Associate-Degree Level versus Baccalaureate-Degree Level
According to the Institute of Medicine (IOM), the improvement in quality of education for health professionals is necessary to continue to meet the needs of the health care delivery system. (“Health Professions,” 2003). Nursing has evolved throughout the centuries; from the male-dominated religious caregivers dated as far back as 250 B.C., to the registration of nursing created by Elizabeth Grace Neil in 1901. Moreover, the continuous rapid advances and demand in health care has prompted alternatives in educational programs. Mildred Montag, the founder of the 2 year Associates degree, created this program to combat scarcity in nursing during World War II. (Creasia and Friberg, 2011, p.15). Countless research and investigation has been conducted to analyze the differences between nurses' competencies prepared at the Associate-degree level to the Baccalaureate-degree level in dealing with the outcome of patient care.
Differences in Curriculum The Associate Degree in Nursing (ADN) is a 2-year program that focuses on clinical experiences and technical competence. On the other hand, the Bachelor’s Degree of Science in Nursing (BSN) is a 4-year program that focuses on preparing professional nurses for acute care, community-based treatment, and the inception of leadership and administrative positions. The BSN level integrates with the infrastructure of knowledge that was built during training at the ASN level in preparation to advance a student's role in the nursing practice.
Differences in Competency of Associates-degree versus Baccalaureate-degree Nurses
Extensive research demonstrated that nurses who obtained a higher level of education contribute to better patient care results. A study that was conducted in multiple hospitals in Pennsylvania was designed to analyze and review patients’ outcomes and mortality rates, which is linked to a nurse’s education level and competency. Many of the facilities surveyed featured a prominent composition of Baccalaureate-educated staff. The result concluded with a potent affirmation that hospitals staffed with better educated nurses has a direct correlation to lower risks of mortality rates and failure to rescue patients within 30 days of admissions. (McHugh and Kelly, 2012). The average proportion of hospitals employing nurses with Baccalaureate degree level of education had a lower mortality rate with better patient treatment outcomes, compared to hospitals with mixed or lesser educated level nurses.
Patient Care Scenario
An example of a nurse/patient care situation that comes into play regarding the comprehension amongst nurses with varied levels of education is with pressure ulcer management. Pressure ulcers are associated with elevated rising health care costs and are significant problems within any health care settings. (Sving, Gunningberg, 2012). Take the case of an 84 yr. old female patient who was initially admitted with Stage 1 PU to her sacrum region, then later developed a Stage 4 nosocomial pressure ulcer. The registered nurse can develope a plan of care for this patient depending on his/her education and experience. An Associate's degree level educated nurse's plans will typically be to obtain initial evaluation from the doctor. Additionally, continuation of turning and repositioning the patient on a schedule of every 2 hours, obtaining a pressure relief mattress, and referring to the Wound Specialist and weekly skin/wound rounds are common procedures. Comparatively, a Baccalaureate degree trained nurse would develop a comprehensive individualized plan of care for this patient. One would consider the patient’s age, mobility, incontinence, nutritional status, and comorbidities; all of which are reflective of how a treatment plan would take part in rectifying the cause and promote future prevention of a decubitus pressure ulcer. (Sving, Gunningberg, 2012). A Baccalaureate level educated nurse would: recommend to the medical doctor the need for a Foley catheter for a patient who is incontinent, obtain/dispense vitamins for nutritional supplementation, involve the dietician during evaluations of said patient’s nutritional and/or hydration needs, and obtain appropriate cushioning devices from the occupational therapist for the patient. Knowledge of at least a few preventative measures, structured risk assessments, and cross-disciplinary collaboration involving other health care team members would ensure a more positive outcome. (Sving, Gunningberg, 2012). In addition, evidence-based care is relevant to a nurse’s clinical practice as this plays an important role in successful assessment and treatment.
Conclusion
Associate's degree nursing education continues to be a relevant and fundamental choice for students entering the nursing profession. However, this shouldn’t be considered the final educational level of someone’s career. The significance of professional advancement in nursing cannot be underestimated. The level of nursing education has been shown to heavily influence nursing care; with a direct relationship between higher nursing education and improved patient outcomes. (Raines and Taglaireni, 2008).