NURS 102: Ch4
What is Accreditation for nursing programs? Why is it important?
"Accreditationis the voluntary review process of educational programs by a professional organization." Accreditation is important because it compares the educational quality of a program to certain standards in order to ensure the said program is of adequatequalityfor the students it will train.
Patricia Benner, PhD, RN, FAAN, and her team @ the Carnegie Foundation for the Advancement of Teaching publisjed
"Educating Nurses: A Call for Radical Transformation" o Called for a BSN as the entry level for RNs and recommended that all RNs be required to earn an MSN within 10 years of licensure. o Found that nurses are undereducated to meet the demands of today's practice
1965: ANA Position Paper
"Educational preparation for Nurse Practitioners and Assistants to Nurses". It did not refer to Medicare and Medicaid. It concluded that baccalaureate education should become the foundation for professional practice.
the school at Teachers College =
"Mother House" of collegiate education because it fostered the initial movements toward undergraduate and graduate degrees for nurses
1912; Nutting published
"The Educational Status of Nursing" focused on students' living conditions, nursing education curricula, and teaching methods
The theoretical, scientific orientation of the BSN program was in sharp contrast to the ________ that was the hallmark of hospital-based diploma education.
"hands-on" skill and service orientation
2008 AACN. The Essentials of Baccalaureate Education for Professional Nursing Practice.
"nurses who graduate from BSN are prepared to practice within complex helath care systems and assme the following wroles: provider of care; designer/manager/coordinator of care; and member of a profession."
NCLEX-RN
(National Council Licensure Examination for Registered Nurses)
Current trends in ADN programs
ADN curricula now offer more nursing credits than she suggested. They also include content on leadership and clinical decision making, abilities that Montag did not anticipate as needed in technical nurses. Because of additions to the curriculum, it is now difficult for students to complete an ADN in only 2 years.
Lysaught Report (1970)
It made recommendations concerning supply and demand for nurses, nursing roles and functions, and nursing education. Priorities identified by the study: The need for increased research into both practice and education of nurses Enhanced educational systems and curricula
NLNAC
National League for Nursing Accreditation Commission
NLNE
National League of Nursing Education
What is the NCSBN?
National council of state boards of nursing Indicated that nursing has responded to challenges to increase the sophistication and innovation in nursing education (2012).
Who opened the first school of nursing?
Nightingale (1860) @ St. Thomas' Hospital in London Principles: The nurse should be trained in an educational institution supported by public funds and associated with a medical school The nursing school should be affiliated with a teaching hospital but also should be independent of it. The curriculum should include both theory and practical experience. Professional nurses should be in charge of administration and instruction and should be paid for their instruction. Students should be carefully selected and should reside in "nurses' houses" that form discipline and character (Nightingale envisioned nursing as a profession only for women) Students should be required to attend lectures, take quizzes, write papers, and keep diaries. Student records should be maintained.
What 4 messages were the central focus of the IOM & RWJF "Future of Nursing" report?
Nurses must practice to the full extent of their education and training. Nurses should attain higher education levels through a system of improved education with seamless progression across degrees. As health care in the United States is being transformed, nurses should be full partners with other health care professionals in this effort. Improved data collection and information infrastructure can result in more effective workforce planning and policy development.
Mildred Montag's ADN program
Short duration to prepare nurse technicians Nurse technicians function under supervision of professional nurses Routine care in acute and long-term settings Intended for end-point degree and not an incremental step to BSN
1996: AACN Position Statement:
The Baccalaureate Degree in Nursing as the Minimal Preparation for Professional Practice. It supports articulated programs which enable ADN nurse to attain BSN.
Growth of BSN was slow because of:
The reluctance of universities to accept nursing as an academic discipline and The power of the hospital-based diploma programs
Goldmark Report (1923) -
a study of nursing education Focused on the clinical learning experiences of students, hospital control of the schools, the desirability of est. university schools or nursing, the lack of funds specifically for nursing education, and the lack of prepared teachers. Some of the findings remain applicable today.
ADN graduates are employed in
a wide variety of settings and usually function autonomously with BSN and diploma graduates.
external degree programs
different from traditional basic nursing education in that students attend NO CLASSES. Learning is independent and is assessed through highly standardized and validated competency-based outcomes assessments, leading to the description "virtual university." Students are responsible for arranging their own clinical experiences in accordance with established standards.
Diploma program =
hospital based nursing education programs. Its reason was to staff the hospitals that operated them; therefore high-quality education of student nurses was OT always the primary concern.
issues with DL
issues of adequate and properly supervised clinical experiences Fraudulent programs
1980: National Commission on Nursing Suggested that the major block to the advancement of nursing was
the ongoing conflict about educational preparation for nurses. Recommendation: Establish a clear system of nursing education including pathways for educational mobility and development of additional graduate education programs (DeBlack, 1991
Nursing leaders of the early 1900s were concerned about
the poor quality of many of the recently formed nurse training programs American Society of Superintendents of Training Schools for Nurses
Accreditation -
voluntary review process of educational programs by a professional organization (ensures quality of education)
After graduation:
Eligible to take the NCLEX-RN
NLN
National League for Nursing
1919: ___ BSN programs.
Seven Most BSN programs were 5 years in duration.
The accrediting agency compares
the educational quality of the program with established standards and criteria.
What is the newest form of basic preparation for RN practice?
ADN
Despite tremendous opposition from proponents of diploma and ADN programs, in 1979 the ANA further strengthened its resolve by proposing three additional positions (ANA, 1979):
1. By 1985, the minimum preparation for entry into professional nursing practice should be the BSN. 2. Two levels of nursing practice should be identified (professional and technical) and a mechanism to devise competencies for the two categories established by 1980. 3. There should be increased accessibility to high-quality career mobility programs that use flexible approaches for individuals seeking academic degrees in nursing.
Before committing to an online program...
1. Do you have the self-discipline needed to keep up with assignments outside a traditional classroom setting? 2. Do you learn best when you can interact with other students and faculty, or do you do well working alone?
Major recommendations of ANA 1965 Position Paper included:
1. Education for all those who are licensed to practice nursing should take place in institutions of higher learning. 2. Minimum preparation for beginning professional nursing practice should be the baccalaureate degree in nursing. 3. Education for assistants in the health service occupations should consist of short, intensive preservice programs in vocational education institutions rather than on-the-job training programs.
what were the 4 key messages of the IOM and RWJF's "The Future of Nursing"?
1. Nurses must practice to the fullest extent of their education and training. 2. Nurses should attain higher education levels through a system of improved education with seamless progression across degrees. 3. As health care in the US transforms, nurses should be full partners with other health care professionals in this effort. 4. Improved data collection and information infrastructure can result in more effective workforce planning and policy development.
Recommendations of Early Studies of Nursing Education
1. Nursing education programs should be established within the system of higher education. 2. Nurses should be highly educated. 3. Students should not be used to staff hospitals. 4. Standards should be established for nursing practice. 5. All students should meet certain minimum qualifications on graduation.
Mary Adelaide Nutting
1907: 1st nursing professor in history and became a pioneer in nursing education (Teachers College)
First BSN program
1909: in University of Minnesota
peak of diploma programs - approximately 2000 programs existed in almost every state
1920s and 1930s
The FIRST nursing school est. as a SEPARATE university department
1924: Yale University: opened its School of Nursing The FIRST nursing school est. as a SEPARATE university department with an individual budget and own dean (Annie W. Goodrich) 1929: Rockefeller Foundation awarded it with $1 million
ADN begun in
1952 as a result of a post-World War II nursing shortage
Melinda Anne "Linda" Richards =
1st trained nurse educated in the US. (Oct 1873)
Identify challenges for nursing education.
2 main challenges: The inability of nursing programs to produce enough nurses to meet society's needs because of faculty and resource shortages. (The number of employed nurses falls short of current needs despite growth of nursing education programs. As the population ages, nurses age as well, meaning retirement numbers will increase to where almost 75% of current nursing faculty will retire by 2019.) The need to transform nursing education to meet the need for quality and safety in an increasingly complex health care environment. (QSEN project was created.)
Characteristics of Pre-licensure Baccalaureate Programs
4-year program. General education + nursing courses. Faculty qualifications - minimum of master's degree BSN graduates are eligible to take licensure exams, prepared to move into graduate programs and advanced practice certification programs.
By 1900: there were ____ hospitals owned and operated nursing programs in the US.
432 Graduation from these programs = diploma.
generic master's degree programs
Accelerated MSN programs for individuals with bachelor's degrees in another field usually require around 3 years to complete and graduates take the NCLEX-RN after completing the generic master's program
Programs for Second-degree Students
Accelerated or fast-track sequence to award a second bachelor's degree or in some cases MSN
Popularity of ADN is due to
Accessibility of community colleges Low tuition costs Part-time and evening study opportunities Shorter duration of programs Graduates' eligibility to take the RN licensure exam
2 agencies are responsible for accrediting nursing educational programs today
Accreditation Commission for Education in Nursing (ACEN) Commission on Collegiate Nursing Education (CCNE)
AACN
American Association of Colleges of Nursing
ANA
American Nurses Association Still continues to urge Congress to increase funding for the Title VIII Nursing Workforce Development Programs.
1970: National Commission for the Study of Nursing and Nursing Education published
An Abstract for Action (Lysaught Report)
Who was the dean of the Yale University nursing school?
Annie W. Goodrich
Isabel Hampton Robb
Chairman of A society that investigated ways to prepare nursing better for leadership in schools of nursing. Held nursing training at "Teachers College" which trained teachers Began as an 8-month course in hospital economics.
How did ADN programs evolve?
Associate's Degree in Nursing programs first evolved in1952 after World War II and are currently the most common type of nursing education in the United States. ADN programs have now evolved to includea higher volume of nursing classes to prepare ADN graduates in leadership and decision making, which before was thought to be unneeded by nurses of this level. ADN programs are now considered to be the first step into BSN programs or master's degrees, but have lengthened from 2 years to almost 3.
When and where was the first BSN program established?
At the University of Minnesota in 1909.
few entry-level __ programs offer half or more classes online
BSN
In the educational system of nursing today, the ADN can be a step in the progression to the
BSN or master's degree
Excelsior College (formerly: NY Regents External Degree Nursing Program)
Beginning in 1970 with an ADN program, Excelsior College now offers ADN, BSN, and MSN degrees, all of which are accredited by the NLNAC It does not offer clinical experiences to those seeking a basic nursing education and as such they are encouraged to seek basic education that includes clinical instruction.
Why is continuing education (CE) important in nursing? How is it measured?
CE is a non-degree seeking way for nurses to maintain expertise during their career. Nurses purse CE themselves, and most states require proof of CE before license renewal. CE is measured by contact hour. For every 50 or 60 minutes nurses spend in a CE course, they receive 1 contact hour of CE credit.
Linda Aiken, PhD, RN, FAAN
Called for increased federal support for the preparation of nurses at the BSN level and higher.
Compare and contrast the DNP and PhD in nursing.
Comparison: Both programs allow nurses to move into higher positions such as professors, administrators at schools of nursing, or even researchers and advanced practitioners. Contrast: a PhD is research-focused, meaning it preparesthe nurse to conduct research and develop a theory. PhD nurses focus on developing the science of nursing. A DNPis a practice-focused degree, which allows the nurse to achieve advanced roles as an NPor nurse-midwife. These 2 types of nurses can work together: PhD nurses can help DNP's develop research, and the DNP nurses can move said research into practice.
Articulated programs
Definition: Mobility between programs Purpose: Facilitate opportunities to move up the educational ladder
More problems with diploma programs
Demanding schedule Duration: 3 years (current programs: 24 months) Most colleges and universities did not recognize diploma programs. Current practice: Diploma programs establish agreements with colleges and universities.
Educational Paths to Become a Registered Nurse
Diploma Programs Baccalaureate Programs Associate Degree Programs
alternate paths: RN-to-BSN Education
Diploma and ADN nurses are given credits to meet certain BSN requirements. Transfer of general education courses Options for advanced placement
Most colleges and universities did not recognize diploma programs. Current practice:
Diploma programs establish agreements with colleges and universities.
(ADN) Based on a model developed by
Dr. Mildred Montag, and fueled by the post-World War II community college movement of the 1950s
Factors that affected decline of diploma programs
Growth of ADN and BSN programs, which moved the education of nurses into the mainstream of higher education Inability of hospitals to continue to finance nursing education Accreditation standards that have made it difficult for diploma programs to attract qualified faculty Increasing complexity of health care, which has required nurses to have greater academic preparation.
earliest form of nursing education in the US.
Hospital-based diploma program
ex of a fully articulated system
Licensed practical (LPN)/vocational nurse (LVN)/ADN/BSN/MSN program in which students spend the 1st year preparing to be an LPN/LVN, and return to the ADN program at a later time. Or continue study in the program after 2 years to earn a BSN and even continue to a master's or doctorate.
Define Licensure and Certification in nursing.
Licensure: a state regulation ofnursing practicethatis required of all individuals at the entry point to practice and must be renewed. Certification: validates a high level of knowledge and proficiency in a particular area of study. This is a professional certification, not something required legally.
what 2 programs have been at the forefront in the development of online programs?
Master's (30% of MSN programs) Doctoral (50% DNP programs)
dramatic decline of diploma based programs when nursing education moved rapidly into collegiate settings
Mid-1960's -Over the past 50 years, 800 to 60 programs
What is the title of the licensure exam taken by Registered Nurses?
NCLEX-RN: National Council Licensure Examination for Registered Nurses.
1982 NLN pub.
Position Statement on Nursing Roles: Scope and Preparation - affirmed BSN as minimum educational level for professional nursing practice and ADN or diploma as the preparation for technical nursing practice.
What does QSEN stand for?
Quality and Safety Education for Nurses "...ensure that futurenursing graduates hadcompetencies in patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, and informatics."
what programs are often offered online?
RN-to-BSN
The Brown Report
Recommendation: Basic schools of nursing must be placed in universities and colleges with an effort to recruit men and minorities.
Accrediting agencies establish standards by which program effectiveness is measured.
Self-study and site visits Continued accreditation Deficiencies
What is the importance of the Goldmark Report and the Brown Report on nursing education / profession?
The Brown Report specifically set out to place schools of nursing within universitiesin order to successfully recruit more men and minorities into the profession / education programs. The Goldmark Report focused mainly on the problems in nursing education and how to fix them, such as by establishing schools of nursing and keeping track of the clinical learning experiences of the nursing students. They also mentioned information of the lack of adequate fundingand prepared teachers at nursing schools.
1948: Lucille Brown:
The Brown Report. Sponsor: Carnegie Foundation.
The IOM (Institute of medicine) published
The Future of Nursing (2010) alongside Robert Wood Johnson foundation (RWJF) *addressed the need to transform the profession of nursing
what is RWJF?
The Robert Wood Johnson Foundation
"Famous trio" of nursing schools:
The first training schools for nurses in the US: 1872 Bellevue Hospital, NY New England Hospital for women and children, New Haven, CT. Massachusetts General Hospital, Boston All were (around) 1 year long.
What is the American Association of Colleges of Nursing (AACN) position statement on entry level nursing educational preparation?
They decided that baccalaureate education should be the main foundation for professional nursing practice. They wanted nurses to be educated in higher learning institutions and have the baccalaureate degree as the minimum preparation for a profession in nursing.
Rhode island Nurses institute Middle College Charter High School in Providence
This school is for high school students who are interested in a career in nursing, and they continue at the school through their first year of college. The curriculum focuses on science and math skills that are necessary to be successful in nursing school and then in practice. The mission of the school is "to prepare a diverse group of students to become the highly educated and professional nursing workforce of the future" (2015).
What is an articulated nursing program?
This type of program gives nursing students opportunity to move up the educational ladder while they are in school. For example, they can complete their LPN/LVN their first year and move on to complete their ADN the second year. After this, they can continue to study further into BSN programs and even master's or doctorate programs later on.
accrediting programs derives authority from the
US Department of Education.
Multiple-entry and multiple exit programs
are difficult to develop a lot of joint institutional planning is needed to work out equivalent courses and to keep the programs congruent with one another. A change in one curriculum dictates changes in all the others. These challenges are why fully articulated programs have been slow to develop.
the most common type of basic nursing education program in the United States
associate degree programs and graduate the most RN candidates of all the basic programs.
There is an increasing understanding that nurses need a _______ degree to qualify nursing as a recognized profession and to provide leadership in administration, teaching, and public health.
bachelor's
Accreditation provides both a
mechanism and a stimulus for programs to initiate periodic self-examination and self-improvement
Florence Nightingale
o Founded modern nursing o Created 1st educational system for nurses o Before, nurses has no formal preparation in giving care because there were no organized programs until the late 1800s. o Argued nursing was not a charitable service, but a respected occupation requiring advanced education.
distance learning (DL)
online degree programs originally intended to improve access for nurses from rural areas; but now students might live in the same town as the school but have significant demands on their time and prefer flexibility of online offerings.
1937: A Curriculum Guide for Schools of Nursing
outlined a 3-year curriculum and influencing the structure of diploma schools for decades after its publication.
Nightingale thought nursing should be __ from hospitals
separate (financially and administratively) (wasn't the case, however, when nursing schools were 1st est.)
1981: California State University Consortium offered a
statewide external BSN program. The California program is for RNs already holding current licenses to practice in the state.
Articulation agreements facilitate
student movement between programs and accept transfer credit between institutions. These result in acceleration or advanced placement.
Who has sought to differentiate the competencies of the ADN nurse from those of the BSN nurse? (since 1990)
the NLN Council of Associate Degree Programs "Educational Competencies for Graduates of Associate Degree Nursing Programs": identified 8 core competencies of ADN education
