Nursing education evaluation

A SYSTEMATIC REVIEW OF BETTER EDUCATED NURSES IMPROVING PATIENT OUTCOMES

ABSTRACT

Background: The health care sectors out of necessity have strived to improve the delivery of health care meted out to our customers. This alone is not the only contributing factor as advances in medically technology as a more informed patient have led to higher expectations from our aging population and the wider community.

 The nursing profession in their efforts to meet the ever increasing demands have instituted a furthering of nursing education by way of the baccalaureate degree programme. This degree does not necessitate the licensure of the registered nurse to practice, and as a consequence, it is not seen as the goal standard.  Therefore, if the nursing profession is to satisfy fully the demands of its work entails across settings, then the baccalaureate degree must be recommended at all entry levels.

Aim: To evaluate if there are improvements in patient care after the completion of the baccalaureate degree in nursing.

Objectives

To identify studies that prove that nurses who have completed baccalaureate degree in nursing improve patient outcomes

To assess the quality of care provided to patients who have completed the baccalaureate degree in nursing.

To calculate the difference in care meted out to patients from nurses who have completed the baccalaureate degree in nursing.

Method: A systematic review of quantitative studies was done through the use of PubMed, peer review articles and Wiley online library. All the studies used in this review had to meet the inclusion criterion that’s presented later in the paper.

Results: 25 papers met the criteria and they were included in this review. These studies includes; lower admission rates and shorter lengths of stay, lower rates of Post- surgery mortality, lower congestive heart failure mortality, decubitus ulcers, and failure to rescue patients care when delivered by baccalaureate degree educated nurses.

Conclusion: The encouragement to pursue higher education in nursing is vitally important if this profession is to be taken seriously. Policy makers must make the baccalaureate degree the gold standard for entry level and stop emphasizing nursing shortages, but focus on the long term benefits provided to patients. The focus should be on the overall improvements in the currents standards in health care and what the nursing profession has done to meet the modern challenges.

Keywords: Baccalaureate degree nurse, BSN (Bachelor of Science in Nursing), hospital mortality, ADN, patient outcome, clinical outcome, patient mortality, length of stay, failure to rescue, Diploma Nurse, 30-day mortality, complications.

Types of participants

The participants chosen were those who are actively involved in caring for patients in healthcare settings. These were the ones considered for the review. Bedside nurses, nurse educators and nurse executives were the type of nurses included in the review process.

Types of intervention (s)

The current review assesses and evaluates studies which analyse the effect of nurses who have a BSN degree or even have higher qualifications on the outcome of the patients. Other types of studies included were those which focused on the differences between the BSN degree or higher to non-BSN.

Types of studies

Some of the studies considered in this review are; Controlled trials, randomized controlled trials, quasi-experiments, and retrospective cohort studies, prospective, before and after studies, together with case controlled studies.

Types of outcomes

Studies which included 30-day mortality, in-patient mortality, and failure-to-rescue, length of stay, work satisfaction and period of stay in job positions among nurses, pulmonary embolism, and duration of hospitalization were considered for this review.

Methodology quality

To ensure the methodology quality of this systematic review, it was imperative to use Critical Appraisal Check-lists for the Descriptive Case Studies. In addition to that, Comparable Cohort/Case-Controlled Studies from several institutions were also used.

Data Collection

Data was taken from some key selected articles which passed the inclusion criteria for the systematic review.

Data Synthesis

Meta-analysis was conducted through the use of OpenMeta-Analyst program and this was done for each one of the following stated outcomes: 30-day mortality, in-patient mortality, and failure-to-rescue, length of stay, work satisfaction and period of stay in job positions among nurses, pulmonary embolism, and duration of hospitalization.

Level of education required for nursing

BACKGROUND INFORMATION

For a long time, there have been a lot of debates on what is the preferred on the optimum level of education for the entry of nurses into practice and the debate has mostly focused on the baccalaureate degree. In most countries, entry into the nursing profession varies from a period of two to four years study period in a hospital-based school nursing, in colleges or universities (thus leading to the completion of a diploma, associate degree, or baccalaureate degree) In addition to that, students who have already completed their bachelor’s degree in other fields are also eligible to receive a bachelor of science in nursing from an accelerated second-degree program. The nursing profession has some entry points, and as much as this has made the profession unique in its way, it has increased confusion as well, more so to the public, health care providers, legislators and potential nursing students. Unfortunately, this lack of professional consistency plus professional recognition is creating more harm than good, but very little efforts are being put to solve the problem. Although there have been several attempts to try and standardize the entry points into the nursing profession, nurse leaders together with educators have encountered challenges in bringing the standardization to fruition.

Goodrich, Nutting, and Wald (1923) conducted the Gold mark Report which was financially supported by the Rockefeller Foundation. The report categorically stated that nurses have to be sufficiently educated in academic institutions and other institutions of higher learning just as is the case with other professions. This education is going to prepare them more adequately so that they are capable of meeting the requirements of health care patients and give recognition to the nursing profession. When conducting the report, education and training of nurses were mostly conducted in hospital-based diploma schools, and we can see nothing much has changed since then. Diploma nursing schools have remained to be the main provider of nursing education even with the introduction of the associate degree in nursing (AND) programs in the 1950s. The reason for the creation of these associate degrees was to alleviate and solve the acute shortage of nurses during the World War 11.

Ellenbecker (2010) goes on to point out that because of technological advancements in the healthcare industry and the emergence of new skills, nurses have to be more educated. It was plainly evident that the apprenticeship technique of providing education to nurses through diploma schools was neither efficient nor adequate and this was having negative implications on the standard care being offered to patients.

Hasse (1990) explains that the reason for establishing associate degree in nursing for nurses was to offer students with knowledge and understanding that could help them to provide care for patients and to provide the students with technical skills as well. The associate degree preparation shortened the time duration of nursing education to two years, previously it was four, and this was done so that a bigger and greater nursing workforce would be produced to meet the growing demand of patients and the acute shortage of nurses.