Clinical Specialty Area
The clinical area chosen was the Heart and Vascular Institute through one of the hospital systems I am employed with. I had been involved with a project that studied the readmissions experienced within the hospital system and established heart failure (HF) and chronic obstructive pulmonary disorders (COPD) were our highest readmission problems. Our organization had found that millions of dollars had been left on the table since the Centers for Medicare & Medicaid (CMS) handed down their final ruling in 2012 regarding reduced payments for preventable readmissions (CMS.gov, 2016).
One of the outcomes of the project was the development of the rapid diuresis unit (RDU) through our Cardiac Decision Units (CDU) at several campuses. I often wondered how the RDU of the CDU was set up and how they function within the system. This is my opportunity to see the operation firsthand, the clientele it serves, the staff, and potential education needs that the department faces.
Developing as an Advanced Nurse Educator
The American Association of Colleges of Nursing (AACN) published report titled The Essentials of Master’s Education in Nursing (2011), where the core framework for all masters educated nurses is laid out to prepare for the dramatic changes seen in the delivery of healthcare today and in the future (American Association of Colleges of Nursing, 2011). I am excited to be with Walden’s vision to implement some advanced practice into the MSN in
The Essentials of Master’s Education in Nursing serves to transform nursing education and is critical to the innovations needed in health care. AACN (2011) Health care is a field that is constantly changing and evolving. Medical professionals are committed to lifelong learning, with an emphasis on seeking out quality care for patients that is based on evidence. Master’s prepared nurses are leaders in this change and are expected to provide the best quality outcomes. Nurses with a master’s degree will be able to enhance society through their lifelong learning and have the skills to build and lead professional teams. Being able to translate evidence into their daily practice as well as incorporate this care throughout the healthcare system as
This outcome is based on the MSN essentials III, IV, and VIII. MSN essential III focuses on quality improvement and safety. A master’s prepared nurse must be skilled in the methods, tools, performance measures, and standards associated to quality, as well as prepared to apply quality principles within an organization. Improvement in the patient safety along with diminishing and eliminating patients harm is the fundamental of quality care. Masters prepared nurses should analyze the information about quality initiatives to improve health outcomes across the continuum of care. They also need to implement evidence-based plans to improve quality and safety as well as compare and contrast several appropriate quality improvement models. MSN IV focuses on applying research outcomes within the practice setting to resolve practice problems. Professional practice in all levels should be grounded in the ethical translation of current evidence into practice. Master’s-prepared nurses are expected to lead continuous improvement processes based on translational research skills (American Association of Colleges of Nursing, 2017). Based on the chamberlain program outcome, I have learned how to provide quality and safest patient care by making an appropriate diagnosis and treating the patient by utilizing the research
Healthcare systems and the way safe, quality health care is delivered are continually changing to better serve patients and communities. Professional nursing practice is a large component in the healthcare system today. Back in the 1960s, professional nursing leaders tried to adopt the bachelor degree programs as the only educational track to become a registered nurse (Creasia & Friberg, 2011). Due to nursing shortages and demands this motive did not hold fast. Individuals entering the nursing profession today must first decide which educational pathway to take to become a Registered Nurse (RN).
In today’s healthcare system, nursing is a challenging field as a result of rapid technological advances and changes in healthcare policies. As a dedicated nursing professional, with a great passion for learning, I strive to stay on top of these changes. I am determined to increase my knowledge to be an instrumental part of providing quality healthcare. The demands of nursing are high; however the rewards are even higher. Nursing requires both a supreme understanding of the science of health, and a caring bedside manner befitting only those who seek a position of such a personal involvement in the well-being of a patient. Academically, I will put forth all of
In the traditional health care model, formal learning is not complete when a physician receives their medical degree and white coat at the end of their academic program. Medical school graduates are required to complete an accredited hospital residency program to become licensed to practice medicine, (Jolly, Erikson, & Garrison, 2013). However, acute care nurse practitioners (ACNPs) are not afforded, nor expected to complete, the same educational requirements. The current expectation that a new graduate ACNP learn their advanced nursing role “on-the-job” is unacceptable and leads to decreased job satisfaction and preparedness. In the every-changing climate of health care, the development of required residency programs for ACNPs should be maintained as a priority.
With an ever-increasing body of knowledge in the field of nursing, more education is being required to enter the field of nursing. Many healthcare institutions are raising the educational requirements in order to become employed or maintain employment in their facilities. Healthcare organizations are transitioning to hiring registered nurses (RN) who have a higher level of education, such as, a graduate from a Baccalaureate Degree Nursing (BSN) program. The goal of these institutions is to have nurses with a broader array of skills that can meet the growing demands of our patient population. BSN prepared nurses are recognized for their well-rounded skills in critical thinking, management, case management and health promotion versus Associate Degree nurses (ADN)/Diploma nurses that focus on direct patient care.
As popular as the ADN is today, there is a huge momentum to encourage nurses to receive their BSN instead of an ADN. Nurses that are already entering the workforce at the BSN level are not only more skilled at following and understanding evidenced based practice, but they are also more prepared to go on to school to complete their masters or doctorate degrees. In the changing face of healthcare, more nurses with advanced degrees will be needed to provide primary care as in the role of nurse practitioners. APRNs are going to be in higher demand in community care, public health nursing, evidence based practice, research, and leadership. Shortages of nurses in these positions create a “barrier to advancing the profession and improving the delivery of care to patients” (IOM, 2010, p. 170). Shortages of APRNs and the increasing need for nurse practitioners to provide primary care is why the IOM is recommending to increase the amount of BSN educated nurses entering the workforce to 80% and to double the number of doctorate nurses by 2020 (IOM, 2010, p. 173) The goal to increase the nursing workforce to 80% BSN educated nurses and double the amount of nurses with doctorate degrees is a formidable goal, but increasingly necessary. Patients are becoming more complex inside and outside of the hospital setting with chronic multiple comorbidities. BSN educated nurses are not only better prepared to care for these
This article reviews the history of Medicare’s Hospital Readmission Reduction Program (HRRP) which began in October 2012. It examines why Medicare and Medicaid initiated the program, clarifies what conditions were originally included in HRRP and analyzes the reasoning behind adding Chronic Obstructive Pulmonary Disease (COPD) to the list of high priority conditions. It also, clarifies what information U.S Centers for Medicare and Medicaid (CMS) take into consideration when calculating readmission rates and points to the fact that high readmission rates could be due to non-hospital factors. The authors review new data that focuses on the potential harm of adding COPD to the list of conditions due to the increased level of patients from lower
The American Association of Colleges of Nursing (AACN, 2011). The essentials of Master’s Education for Advance Practice Nursing. Retrieved July 09. 2015.
Some of the dilemmas associated with today’s nursing force are: Many are under-educated and task-oriented, unaware of their patient’s plan of care, medical histories, or pertinent results. Too many rely on clinical coordinators and team leaders, when it comes to critical thinking, therefore, miss out on the vital fundamentals, which make nursing such an honorable profession (Grietens, 2007, p. 10). In order to create a stronger, more knowledgeable nursing workforce, entry-level requirements for RNs, as well as APRNs, need to be uniform. In addition, research shows bachelors and masters prepared nurses, result in better patient outcomes. An example of a proposed solution includes:
Nurses must achieve a higher level of education in order to meet the demands of evolving health care and the changing needs of patients (Rosseter, 2012). Nurses will need to be prepared for a broader scope of practice and to maintain quality within the health care setting. Associate degrees are still valuable tools when used as stepping stones to baccalaureate programs and performing the technical aspects of nursing. BSN-educated nurses are equipped with a more diverse skill set that assists them in leading and reacting appropriately in critical situations. In addition, they have the opportunity to pursue advanced practices. Baccalaureate programs can help develop a good or adequate associate degree nurse, into an outstanding nurse.
Nursing is one of the most popular professions in healthcare. To become a professional nurse, one must acquire certain level of education, whether it is at associate or baccalaureate degree level. Once becoming a nurse a number of professional standards must be maintained to stay abreast with the profession. In that respect, the Institute of Medicine (IOM) in its 2010 report had suggested many recommendations focusing on the future of nursing. The aim of the report is to put forth recommendations that allow nurses to “(1) ensure that nurses can practice to the full extent of their education and training (2) improve nursing education, (3) provide opportunities for nurses to assume leadership positions and to serve as full
Many people believe mandatory residency programs for newly licensed nurses are long overdue. The knowledge needed to practice nursing has grown to include health policy, ethics, public health, research, healthcare delivery improvements, as well as leadership skills. Nurses are part of the multi-disciplinary team and must work together with healthcare providers who possess masters or doctoral degrees. Nursing school prepares nurses with the basic information they need to know in order to practice safe nursing. However, modern nurses are faced with ever increasing demands. New nurses must know how to collaborate with the healthcare team, manage their priorities, stay organized and recognize life-threatening situations. Many new grads are overwhelmed with the demands of nursing, which can lead to compromised patient care and safety. Formalized, supervised guidance will improve patient care and retain nurses. The study also recommended doubling the amount of nurses with a masters or doctoral degree by 2020 in order to provide an adequate supply of nurses who are able to assume nurse faculty, primary care providers, and researcher positions.
With a consistent change in modernizing medicine, along with the continuing advancement in technology, continuing education in nursing is essential for a variety of reasons. The nurse’s main concern is providing safe, efficient, and effective patient care with positive patient outcomes. This paper will examine the differences in competencies between nurses prepared at an associate-degree level versus a baccalaureate-degree level, in order to provide an evidenced-based understanding of the variation in the educational preparation of nurses.
There is no doubt that the health care system is constantly changing and working to improve its flaws, to the best of its ability. Whether nurses like it or not we are a part of the ever changing health care system. “With more than 3 million members, the nursing profession is the largest segment of the nation’s health care workforce” (Institute of Medicine [IOM], 2010, p. 1). The Institute of Medicine believes that nurses should be active in transforming the profession of nursing, along with the health care system. Regardless, of backgrounds, race, and age all nurses can contribute to the future of the nursing profession. The following paper will discuss the Institute of Medicine’s nursing expectations and recommendations, as well as the opportunity to becoming a clinical nurse instructor.