Highly Qualified Nursing Workforce

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Creating a More Highly Qualified Nursing Workforce
Quality patient care hinges on having a well educated nursing workforce. Research has shown that lower mortality rates, fewer medication errors, and positive outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. The American Association of Colleges of Nursing (AACN) is committed to working collaboratively to create a more highly qualified nursing workforce since education enhances both clinical competency and care delivery. This fact sheet looks at today’s nursing workforce; highlights research connecting education to outcomes; and outlines the capacity of four-year colleges to enhance the level of nursing education in the U.S. Snapshot of Today’s Nursing Workforce

 According to the 2008 National Sample Survey of Registered Nurses conducted by the Health Resources and Services Administration (HRSA), nursing is the nation's largest health care profession with more than 3 million registered nurses (RNs) nationwide. Of all licensed RNs, 2.6 million or 84.8% are employed in nursing.

 The sample survey also shows that 50.0% of the RN workforce holds a baccalaureate or graduate degree while 36.1% earned an associate degree and 13.9% a diploma in nursing.  Graduates of entry-level nursing programs (baccalaureate degree, associate degree and diploma) sit for the NCLEX-RN© licensing examination. The fact that new nurses pass the licensing exam at the same rate does not mean that all entry-level nurses are equally prepared for practice. The NCLEX tests for minimum technical competency for safe entry into basic nursing practice. Passing rates should be high across all programs preparing new nurses. This exam does not test for differences between graduates of different programs, measure performance over time, or test for all of the knowledge and skills developed through a baccalaureate program.  In October 2010, the Institute of Medicine released its landmark report on The Future of Nursing, initiated by the Robert Wood Johnson Foundation, which called for increasing the number of baccalaureate-prepared nurses in the workforce to 80% and doubling the population of nurses with doctorates. The expert committee charged with preparing the evidence-based recommendations contained in this report state that to respond “to the demands of an evolving health care system and meet the changing needs of patients, nurses must achieve higher levels of education.”  The National Advisory Council on Nurse Education and Practice (NACNEP), policy advisors to Congress and the Secretary for Health and Human Services on nursing issues, has urged that at least two-thirds of the nurse workforce hold baccalaureate or higher degrees in nursing by 2010.  In March 2005, the American Organization of Nurse Executives (AONE) released a statement calling for all for registered nurses to be educated in baccalaureate programs in an effort to adequately prepare clinicians for their challenging and complex roles. AONE’s statement, titled Practice and Education Partnership for the Future, represents the view of nursing’s practice leaders and a desire to create a more highly educated nursing workforce in the interest of improving patient safety and providing enhanced nursing care. Research Linking Nursing Education to Patient Outcomes

AACN and other authorities believe that education has a strong impact on a nurse’s ability to practice, and that patients deserve the best educated nursing workforce possible. A growing body of research reinforces this belief and shows a connection between baccalaureate education and lower mortality rates.  In an article published in Health Services Research in August 2008 that examined the effect of nursing practice environments on outcomes of hospitalized cancer patients undergoing surgery, Dr. Christopher Friese and colleagues found that nursing education level was significantly associated with patient outcomes. Nurses prepared at the...
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