1. 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

2. 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

3. Why is a BSN important? Higher functioning in critical skills: Critical thinking Communication Leadership Assessment Teaching Counseling Case Management Health Promotion (Rosseter, 2012)

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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.

11. 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

12. Comparison of Baccalaureate and Non-baccalaureate Nursing Programs The Educational Impact on Nursing RN-BSN Programs: Benefits, Incentives, and Barriers Conceptual Framework Literature Review

13. 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.

14. 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

15. 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

16. 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

17. 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

18. King’s Theory of Goal Attainment Imogene King’s Conceptual Framework for dynamic nursing interactions (Sieloff-Evans, 1991, pg.6)

19. Methodology Study Plan

20. 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

21. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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.

31. The Survey Instrument The Second-Year Associate Degree Nursing Student Questions

32. 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: _____________________________________

33. 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

34. 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

35. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. Three Open-Ended Questions Students are to complete ALL questions

42. 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…

43. Conclusion Findings can assist nursing programs to foster better transitions from ADN programs to BSN through effective bridge programs