Post on 23-Dec-2015
Reasons Identified by Associate Degree Nursing Students for Planning to Attend a Baccalaureate Completion Nursing Program Within Five Years of Graduation
Candice Kiskadden, BSN, RN
Abstract Overview
Mixed design, descriptive study
Approximately 100 nursing students
Data collected using anonymous survey technique
King’s Theory of Goal Attainment
Nursing programs can benefit from findings
Why is a BSN important?
Higher functioning in critical skills:
Critical thinking
Communication
Leadership
Assessment
Teaching
Counseling
Case Management
Health Promotion
(Rosseter, 2012)
Encouraging more BSNs
Very few ADN RNs advance to BSN
BSN RNs have better patient outcomes
ANA, NLN, AACN support BSN as entry-level nursing
BSN education equals higher level of critical clinical reasoning
Background of the Problem
Three pre-licensure pathways for RNs Diploma Associate degree Baccalaureate degree
Same NCLEX-RN
80% overlap in RN responsibilities in ADN versus BSN
Other healthcare professionals require a master’s degree
To identify reasons why second year associate degree nursing students are planning to or not to pursue their baccalaureate degree within five years.Statement of the Problem
What reasons were identified by final semester, second year ADN students as contributing to their decision to obtain their BSN within 5 years? Research Question
Need for the Study
A gap in the current literature why ADN students do not choose RN-BSN Programs
Insight to encourage current ADN students to pursue a BSN
Advancement of professional nursing
Significance of the Problem
2010 IOM “The Future of Nursing” recommends at least 80% of nursing workforce have BSNs
2008-2010 data from US Dept. of HHS: only 44.6% are BSN prepared
RNs with a BSN are prepared to problem solve at a higher level
RNs with a BSN have better patient outcomes
Assumptions
Student nurses who participate will give honest answers to survey questions.
Findings will be based solely on the perspective of the student nurses.
King’s Theory of Goal Attainment provides a sound theoretical foundation for this study.
Limitations
Small sample size
Data from one geographic location in NW PA
Sample from one private Catholic university
Sample size may not be depictive of the focus as a whole
Participating student nurses may not represent the population whole
King’s Theory of Goal Attainment may not be an accurate reflection of the reasons identified
• Comparison of Baccalaureate and Non-baccalaureate Nursing Programs
• The Educational Impact on Nursing• RN-BSN Programs: Benefits, Incentives, and Barriers• Conceptual Framework
Literature Review
Overview
Patient outcomes drive the nursing profession
Schools have adapted to healthcare needs
No real change in practice for BSN has occurred
Emphasis needs to be placed on the importance of a BSN to be a professional nurse.
Comparison of Baccalaureate and Non-baccalaureate Nursing Programs
Nursing supervisors often do not rate performance of BSNs and ADNs differently Less perceived value of BSN Contradicts nursing literature
If nursing supervisors do not value BSN-prepared RNs, non-baccalaureate RNs are less likely to value BSN
Health care facilities with increased BSN RNs have better patient outcomes
The Educational Impact on Nursing
Aiken, Clarke, Cheung, Sloane, and Silber (2003): 10% increase in the proportion of BSN RNs equaled a 5%
decrease in patient mortality and odds of failure to rescue
Friese, Lake, Aiken, Silber, and Sochalski (2008): Increased BSN RNs had lower odds of patient death and lower
levels of failure to rescue
With RN-BSN Programs, a culturally, socio-economically and ethnically diverse RN workforce is possible
Recognition of importance of RN-BSN Programs from nursing governing bodies
RN-BSN Programs: Benefits, Incentives, and Barriers
Improved patient outcomes
Opportunity for all RNs to be BSN prepared through RN-BSN Programs
70% of RNs are diploma or ADN, only 15% currently will achieve BSN or higher
RNs who felt likely to have success in RN-BSN Programs were more likely to pursue BSN
Incentives:• Right time in life• Options• Personal goal achievement• Professional identity• Peer encouragement• User-friendly RN-BSN Program
Barriers:• Time• Fear• Lack of recognition for
experiential knowledge• No differential treatment• Negative past school experiences
Imogene King’s Theory of Goal Attainment: Application to the Study
The “action” of nursing students to consider options like RN-BSN Programs
Optimum use of resources to reach full potential
RN-BSN Programs can influence RNs to optimally use resources and reach their full potential
King’s Theory of Goal AttainmentImogene King’s Conceptual Framework for dynamic nursing interactions
(Sieloff-Evans, 1991, pg.6)
MethodologyStudy Plan
Research Design
A mixed-design, descriptive study
Uses both quantitative and qualitative data
The survey: Three questions related to demographic data items and Eight closed-ended study questions
Calculated using descriptive statistics Thematic analysis of three open-ended study items
Presented in the narrative
Setting
The study will be conducted at a private, Catholic university, located in Northwestern Pennsylvania Pending IRB approval
The university has approximately one hundred second year nursing students enrolled each year
Sample
Includes second year nursing students enrolled in an associate-degree nursing program in the spring of 2014
Convenience sample
Only second level nursing students will be used
Ethical Considerations
Participation is strictly voluntary
Permission will be obtained from the IRB
Return of the reply considered consent for participation
No names or identifying data will be collected for confidentiality
No risks posed to participants or coercion through distribution of the surveys
Instrumentation
A 14-item survey instrument used for data collection Developed specifically for this study Factors identified in the review of literature King’s Theory of Goal Attainment
Survey items will be: Designed to elicit specific responses
Second-year associate degree nursing students Decide to not pursue a BSN within five years Plan to pursue a BSN within five years
Instrumentation Continued
Survey instrument includes: 3 demographic data items 8 closed-ended study questions Calculated using descriptive statistics Thematic analysis of three open-ended study
items presented in the narrative
Instrumentation Continued
The questionnaire will include: Demographic data
Age Gender Home city and state
Collected to enhance the description of the sample Open-ended questions
May be quoted to enhance discussion
No way to attribute any specific quote to any individual student who participates in the study
Data Collection
Obtain approval of the university’s IRB
Data will be collected from the second-year nursing students Arrangements will be made to identify the appropriate classes
Data Collection Continued
On an approved date and identified time: Online survey questionnaire Using Blackboard learning platform Overview presentation of study and request for participation Students will be able to review instructions for completion Contact information will be listed Reinforcement of anonymity No names will be able to be retrieved from the survey
Data Analysis
3 demographic data items
8 closed-ended study items Calculated using descriptive statistics Findings will be presented
Thematic analysis of the 3 open-ended study items Common “themes” in answers Findings will be presented in the narrative
Time Schedule
Students will be given sufficient time to complete the survey during the visited class.
Data collected over two classroom days for each of the second year nursing student classes.
Data analyzed within the week of collection
Completed within 3 weeks of the study.
The Survey InstrumentThe Second-Year Associate Degree Nursing Student Questions
Demographic Data My age is:
[ ] at least 18 years of age, but less than 23 years of age
[ ] at least 23 years of age, but less than 28 years of age
[ ] at least 28 years of age, but less than 33 years of age
[ ] at least 33 years of age, but less than 38 years of age
[ ] at least 43 years of age, but less than 48 years of age
[ ] 48 years of age or older
My gender is: [ ] Female [ ] Male
Identify your city and state of residence (your home town).
City: _____________________________________
State: _____________________________________
Study Data: The First Question
After obtaining my Associate of Science in Nursing degree, I plan to pursue a Bachelor of Science in Nursing by enrolling in a RN-BSN Program within the next 5 years.
[ ] Yes [ ] No
Study Data Continued
An associate degree to baccalaureate degree in nursing (RN-BSN Program) is worth the time commitment to me.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Study Data Continued
An ADN nurse is considered to be a professional nurse.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Study Data Continued
An ADN program of study prepares me nursing equally for the workforce as a BSN program of study.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Study Data Continued
An associate degree in nursing offers me the same level of practice and nursing care as other nursing tracts (Diploma, BSN) at a lower educational expense.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Study Data Continued
A baccalaureate degree in nursing provides me more opportunity for advancement in the workforce.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Study Data Continued
Having a baccalaureate degree will allow me to make more money in my lifetime than an associate degree in nursing.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Study Data Continued
A baccalaureate degree provides me more opportunity for advancement in the workforce.
[ ] completely agree [ ] somewhat agree [ ] neither agree nor disagree [ ] somewhat disagree [ ] completely disagree
Three Open-Ended QuestionsStudents are to complete ALL questions
Open-Ended Questions
Reasons why I would obtain my BSN after graduating from an ADN program…
Reasons why I would NOT obtain my BSN after graduating from an ADN program…
I would look for a RN-BSN Program that offers…
Conclusion
Findings can assist nursing programs to foster better transitions from ADN programs to BSN through effective bridge programs