Issue link: https://beckershealthcare.uberflip.com/i/759111
42 Executive Briefing An Educational Innovation Is Helping Healthcare Achieve its Goals for Nursing By F. Patrick Robinson, PhD, RN, FAAN, Dean, School of Nursing and Health Sciences at Capella University R egistered nurses represent the largest health profession with approximately 3.1 million members, according to the U.S. Department of Labor Statistics. There are few, if any, aspects of healthcare delivery that are not dependent on nurses, who in turn substantially impact patient, systems and population outcomes. Yet despite decades of dialogue, advocacy and compelling evidence, educational preparation for professional nursing remains fragmented with only 55 percent of RNs holding a baccalaureate degree or higher. Complicating the matter is the fact that regulatory scope of practice, established through the RN license, is not differentiated by education level. All graduates of entry-level nursing programs take the NCLEX- RN licensing examination; the test only assesses the minimum technical competency for safe entry into basic nursing practice, according to the American Association of Colleges of Nursing. The test does not acknowledge differences between graduates of different programs, measure performance over time or assess the knowledge and skills a nurse developed through a baccalaureate program. Therefore, entry-level nurses are differentially prepared to practice when they start their careers based on their education. Research suggests increasing proportions of baccalaureate prepared nurses results in decreased patient mortality, failure to rescue, length of stay and readmission rates. Based on the growing evidence and consensus among thought leaders in nursing and healthcare, the Institute of Medicine — now the National Academy of Medicine — recommended in its landmark Future of Nursing Report that at least 80 percent of RNs hold the minimum of a baccalaureate degree by 2020. The need to advance one's nursing education and healthcare employers' need to facilitate advancing nursing education present significant challenges. While practicing nurses may be highly motivated to return to school, time availability tends to be scarce due to professional and personal responsibilities. Cost is also a barrier, which is oftentimes added to the burden of increasing student debt from previous degrees. In addition, nurses logically gain knowledge, skills and competencies through their practice and commitment to continuing education necessitated by the dynamic nature of the practice environment. Thus, there is a psychological barrier to the specter of sitting through classes learning content that may have been mastered long ago. This latter issue is often perceived by experienced nurses as disrespectful as it negates their real-world experiences in favor of academic learning. What if There Was a Better Way? Higher education, including nursing, must evolve toward more efficient, cost-effective models. In the distant past, nurses returning to school for a bachelor's degree were required to repeat in-hospital clinical practice experiences, even though their RN license demonstrated competency in entry-level clinical practice. Eventually, schools granted registered nurses transfer and prior learning credit for significant portions of baccalaureate education. While nursing has been moving toward a more streamlined path to baccalaureate education for RNs for some time, traditional academic models and practices have hindered further progress. Traditional education programs are divided into credit hours, a measure that equates to a number of contact hours spent in a classroom with a professor in a given week. Online learning shook up this definition, but regulators and accreditors settled on a loosely seat time-in-a-classroom equivalency as a standard. The credit hour has a storied history. Developed shortly after the turn of the 20th century, the credit hour was established by the Carnegie Foundation as a way to determine which educators would be eligible for their new pension program. It was simply a way to measure volume of time spent working. However, it quickly became a simple and useful organizing concept that higher education literally built itself around. Today the credit hour is central to everything from admission requirements, financial aid eligibility, tuition rates and faculty productivity. Sponsored by: "While nursing has been moving toward a more streamlined path to baccalaureate education for RNs for some time, traditional academic models and practices have hindered further progress. "