Chapter 3 Nursing Education and Research Fundamentals of Nursing: Standards & Practices, 2E.

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Transcript of Chapter 3 Nursing Education and Research Fundamentals of Nursing: Standards & Practices, 2E.

Chapter 3

Nursing Education and Research

Fundamentals of Nursing: Standards & Practices, 2E

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Nursing Education

Overview• An entry level educational program means

that the program prepares graduates to write a licensing examination.

• Graduates of registered nurse programs write the NCLEX-RN examination.

• Graduates of licensed practical/vocational programs write the NCLEX-PN exam.

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Licensed Practical Nursing• LPNs/LVNs train in basic nursing skills to

provide client care under the guidance of an RN or other licensed provider.

• LPN/LVN programs are 9 to 12 months in length.

• Once licensed, practical nurses are prepared to work in structured settings (i.e., hospitals) under RN supervision.

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Registered Nursing• RNs are prepared for entry in practice

via associate degree, baccalaureate degree, and diploma programs

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The ANA’s 1965 Position Statement identified two entry levels of educational preparation: baccalaureate degree as the minimum preparation for professional practice; associate degree for technical practice.

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Associate Degree in Nursing• Programs are typically two years in length.• Programs are usually located in community

colleges.• In the 1950s, Mildred Montag introduced the

notion of associate degree nursing.• Programs focus on basic skill preparation

and, traditionally, emphasized clinical practice in the hospital setting.

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Diploma Program in Nursing• Programs vary in length from 2 to 3

years.• Programs are hospital-based nursing

education.

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• Diploma programs have always been associated with providing nursing students with strong hospital-based, clinical experience.

• With the decline in hospitalized patients, diploma programs have expanded their practice sites into the community.

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Baccalaureate Degree in Nursing• In the early 1900s, baccalaureate

programs were established to provide students with a liberal arts education.

• Program is typically, a four year program that awards the Bachelor of Science degree in nursing (BSN).

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• Major components of the program include liberal education, professional values, core competencies, core knowledge, and role development.

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Enrollment Trends in Nursing Programs• According to the National League for

Nursing (NLN), enrollments in all entry level nursing programs have decreased between 1995 and 1999.

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Nontraditional Entry Level Programs• Second degree programs, master’s, or

doctoral degrees as entry level are examples of nontraditional programs.

• These programs build on the students’ prior education and/or experience.

• They provide the student with several years of accelerated nursing education.

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Postgraduate Programs• Nurses wanting to expand their clinical

practice in a specialty area could enroll in postgraduate, non-degree granting programs.

• Postgraduate programs are 9 to 12 months in length.

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• Graduates are eligible to apply for licensure as an advanced practice nurse with the State Board of Nursing.

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Graduate Nursing Education• The master’s degree in nursing allows

nurses to expand their roles: educator, administrator, or advanced practitioner.

• Doctoral programs in nursing build on the master’s preparation with an emphasis on the application of research findings to clinical practice.

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• Enrollments in master’s programs have increased significantly from the 1970s to the 1990s.

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Staff Development and Continuing Education• Both are used to maintain the requisite

knowledge and skill needed for comtemporary practice in addition to a formal academic degree.

• Orientation and in-service development is critical to maintain high quality of care.

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Education Reform Mandates• The PEW Health Professions Commission

issued a report entitled Healthy America: Practitioners for 2005 describing competencies for health professionals.

• Nursing leaders embraced these competencies as consistent with the issues raised in Nursing’s Agenda for Health Care Reform (ANA, 1991).

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Trends in Nursing Education• Competency development and

differentiated practice• Enrollments• Instructional strategies• Nursing faculty

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• Advanced educational preparation• Licensure• Size of work force• Delivery of care

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Research

Historical Development• Florence Nightingale combined client

care with research to show “the impact of disease…”.

• In the 1800s, societal norms and the “training” versus “education” of nurses impacted nursing research negatively.

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• With the integration of nursing into higher education, the role of researcher became a natural acquisition for nurses.

• Nursing research from 1940 to 1965 focused on educational curriculum questions as well as the roles and characteristics of nurses.

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• The Journal of Nursing Education was established in 1952 to inform nurses about clinical research; this goal was not achieved until the mid-1970s.

• In 1974, the ANA House of Delegates passed a resolution calling for more clinical research.

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Research Process• Quantitative research involves the

systematic collection of numerical information.

• Qualitative research involves the systematic collection and analysis of more subjective narrative materials.

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Types of Research Design• Historical• Exploratory• Evaluative• Descriptive• Experimental• Quasi-experimental

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Roles of the RN in Research• Nurse scientist• Principal investigator• Research team member• Research consumer• Advocate for research clients

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Rights of Research Participants• Self-determination• Privacy• Anonymity• Fair treatment• Protection from discomfort and harm• Informed consent

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Application - Research Articles• When an article is written by one or

more researchers, it is called a primary source.

• When an author addresses the research of someone else, it is referred to as a secondary source.

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Organizational Structure• The National Institute of Nursing

Research promotes research and the training of researchers in universities, hospitals, and research centers.

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• The Agency for Health Care Research and Quality supports research designed to improve the quality of health care, reduce costs, and broaden access to essential health care services.

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Trends in Nursing Research• With the identification of clear,

significant priorities for study, striving for excellence in the evolving knowledge base, and confirming study findings, nurse researchers are providing a scientific position from which to address health care issues and guide nursing practice.