ADN vs. BSN: Why the BSN is More Beneficial Chelsea Dick Ferris State University NURS 450

Objectives Demonstrate understanding of 2020 BSN initiative Recognize the relationship between nursing education and patient outcomes Identify benefits of BSN degree

Introduction… BSN vs. ADN Controversy in nursing Benefits of a BSN Time and Money Same recognition? Controversy in nursing “Institute of Medicine (IOM) calls for increasing the proportion of baccalaureate-educated (BSN) nurses in the workforce to 80% by 2020” (Yakusheva, Lindrooth, & Weiss, 2014) 80:20 by 2020 Initiative Benefits of a BSN Reduction of mortality rates in patients Magnet status hospitals hire a higher percentage of BSN nurses Stronger professional level skills (American Association of Colleges of Nursing, 2014)

Theory Intellectual Capital in Nursing Theory Self Determination Theory Analyzes the sources of nursing knowledge available within an organization and describes its relationship to patient and organizational outcomes (Covell & Sidani, 2013) A theory of motivation and personality that addresses three universal, innate, and psychological needs: competence, autonomy, and psychological relatedness (Self Determination Theory, 2015)

Interdisciplinary Perspective Integrate clinical knowledge with community resources Broader and stronger scientific knowledge to address complex healthcare needs Work with colleagues educated at masters degree or higher level

Assessment of Health Care Environment Policy Directly and indirectly affects nursing practice All professional nurses have the responsibility of participating in the process of policy development BSN nurses more familiar with EBP process ADN nurses have less leadership/policy development education (Mailloux, 2011)

Assessment of the Health Care Environment Cont’d. Resources Quality & Safety “The means that are available to a health care system for delivering services to a population” (Sleeth, 2012) BSN nurses aware of available resources and access to intra- and inter- professional resources ADN nurses have a more “skills-focused” degree BSN nurses report feeling better prepared than ADN counterparts in EBP, research skills, quality improvement, and applying tools and methods BSN nurses receive 2-3 times more clinical training Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower mortality and morbidity rates among patients (Blegen, Goode, Park, Vaughn, & Spetz, 2013)

Underlying Assumptions BSN ADN More opportunities for advancement (manager, educator) More expensive and time consuming program More desirable to employers BSNs make more money (Beth-El College of Nursing & Health Sciences, 2013) Less expensive program Less time consuming Lower NCLEX pass rates (National Council of State Boards of Nursing (NCSBN), 2015) Still considered an RN Tend to work at bedside in hospitals and in skilled and long-term care nursing facilities (Robin, 2015)

Root Cause Analysis: Pressure ulcers can happen under the care of any nurse (any experience level) Research shows higher percentage of pressure ulcers/skin breakdown injuries occur under the care of an ADN nurse EBP and emphasis on safety and quality of care beneficial to BSN nurse (Blegen, Goode, Park, Vaughn, & Spetz, 2013)

Inferences BSNs are more likely to have extended available resources, familiarity with EBP, better research skills, more clinical experience, and lower mortality and morbidity rates ADNs are not as extensively prepared concerning resources, quality and safety, and less leadership/policy education

Implications/Consequences Lack of BSN nurses could increase morbidity and mortality rates With increased negative patient outcomes, job satisfaction decreases Increased amount of lawsuits if serious negative patient outcome occurs Less competent nursing workforce

Recommendations Pursuing BSN degree is recommended Research supports better patient outcomes with higher education Research bridge programs if already have an ADN Online RN-BSN programs exist if attending on campus is not an option Heavily consider the benefits of attaining a BSN when trying to decide on a nursing program to attend

QSEN Competencies Patient centered carehttps://www.youtube.com/watch?v=U4uSMptxQN M Teamwork and collaboration EBP Quality Improvement Safety Informatics

ANA Standards Standard 8: Education Standard 9: EBP and Research Standard 12: Leadership Standard 13: Collaboration All of these standards are met through obtaining a BSN degree These concepts are incorporated throughout various courses in the BSN program

Benefits of BSN degree over ADN degree… Decrease in morbidity and mortality rates Stronger professional skills & easier to advance career More desirable to employers Stronger scientific knowledge base Higher job satisfaction scores Many more!

Why did you pursue a BSN degree? Why Chief Nursing Officers prefer BSNs: Better critical thinking skills Better patient outcomes Increased patient safety & quality of care Recognize distinct differences in competencies based on education Stronger communication and problem solving skills (nursing diagnosis, etc) (American Association of Colleges of Nursing, 2014)

References American Association of Colleges of Nursing. (2014). Creating a more highly qualified nursing workforce [Fact sheet]. Retrieved from http://www.aacn.nche.edu/media-relations/NursingWorkforce Beth-El College of Nursing & Health Sciences. (2013). Why should I get my B.S. degree in nursing? University of Colorado Colorado Springs. Retrieved from http://www.uccs.edu/Documents/bethel/ RN_BSN_DUAL/RNBSNDual_WhyBSN_10102012.pdf Blegen, M. Goode, C., Park, S., Vaughn, T., & Spetz, J. (2013). Baccalaureate education in nursing and patient outcomes. JONA: The Journal of Nursing Administration, 43(2), 89-94. Covell, C., & Sidani, S. (2013). Nursing intellectual capital theory: Implications for research and practice. Online Journal of Issues in Nursing, 18(2), 2. Fagin, C., & Milbank Memorial Fund. (2001). When care becomes a burden diminishing access to adequate nursing. New York, NY: Milbank Memorial Fund

References cont’d. Mailloux, C. (2011). Using the essentials of baccalaureate education for professional nursing practice (2008) as a framework for curriculum revision. Journal of Professional Nursing, 27(6), 385-389. National Council of State Boards of Nursing (NCSBN). (2015). NCLEX statistics from NCBSN. National Council of State Boards of Nursing. Retrieved from https://www.ncsbn.orgs/3826.htm Robin, Suzanne. (2015). The types of jobs i can get with an associates in nursing. In Chron. Retrieved from http://work.chron.com/ types-jobs-can-associates-nursing-9742.html Self Determination Theory. (2015). In Self Determination Theory. Retrieved from http://www.selfdeterminationtheory.org/ domains/education Sleeth, J. (2012). Health Systems resources and resource constraints. In Global Health Education Consortium. Retrieved from http://www.cugh.org/sites/default/files/content/resources/cugh-health-systems- resources-and-resource-constraints Yakusheva, O., Lindrooth, R., & Weiss, M. (2014). Nurse value-added and patient outcomes in acute care. Health Services Research, 49(6), 1767.