Opening Remarks
New recommendations from influential agencies such as the Institute of Medicine, American Nursing Association, and American Association of Colleges of Nursing require nurses to hold a Bachelor of Science (BSN) degree to enhance patient care outcomes (Grant, 2014; Jones, 2015). In realization of the fact that most nurses in Kendall Regional Medical Center hold associate degrees, it is important to prepare nurses on the implications of the intended regulatory change in nursing education. This memo intends to create nursing awareness by providing specific information about the intended change in regulatory requirements and how it will affect nursing procedures and patient care outcomes.
Target Audience
This memo targets nurses working within the various departments within the facility who are yet to earn a BSN or a baccalaureate degree in nursing. This group entails veteran and new RNs with an associate degree or diploma, public health nurses with an associate degree, and other nursing professionals in need of advancing their education.
Regulatory Requirement
Due to the changing dynamics in the healthcare environment, various agencies that regulate and accredit nurses are now strongly supportive of the BSN entry into practice to ensure that nurse professionals are better equipped to meet the needs of the complex healthcare system.
Organizations such as the Institute of Medicine, the American Nursing Association, the American Association of Colleges of Nursing, and the Association of California Nurse Leaders have all recommended that the BSN or baccalaureate degree be the minimum standard of entry into RN practice to provide nurses with the necessary educational background to deliver quality nursing and increase patient quality outcomes (Grant, 2014; Robert & Glod, 2013; Vernon, Chiarella, & Papps, 2011).
At the state level, it comes to the notice of Kendall Regional Medical Center that many states across the United States are now requiring a BSN or a baccalaureate as the minimum standard for certification as a registered nurse or a public health nurse (Sarver, Cichra, & Kline, 2015). Based on the fact that this health facility operates across several states, it is important to initiate a focused effort that will ensure that our nurses can attain the minimum educational requirements.
These new requirements are supported by some provisions of the Affordable Care Act (ACA) demanding that healthcare organizations should place more focus on chronic and preventive care if they are to develop the capacity to meet current healthcare needs (Dykema, 2014). Stakeholders in the healthcare sector agree that the ADA requirement will compel nurses to acquire more leadership and coordination and leadership competencies to be able to fit into the new system. These competencies are not normally taught as part of the associate-degree curriculum, hence the need for nurses to earn a four-year BSN degree if they are to secure their jobs (Jones, 2016).
Internal Policy Changes
Owing to the regulatory requirement on nursing education, Kendall Regional Medical Center will implement the following internal policy changes:
- The facility will no longer be accepting applications from registered nurses and public health nurses with an associate degree or diploma for employment
- The minimum standard of entry into RN practice will be a BSN or higher to provide an enabling environment for the health facility to comply with the new requirement
- Staff members with two-year associate degrees will be required by the hospital’s administration to enroll in universities to earn a BSN or a baccalaureate as a basic requirement
- The health facility will provide a grace period of six years for currently licensed registered nurses with an associate degree or diploma programs to upgrade to a BSN, as required by the regulatory standard
- Nurses with an associate degree or diploma programs are encouraged to enroll in part-time or online BSN programs to gain the necessary skills and competencies as they continue providing services to the facility
- The facility will arrange for in-house financial assistance for employed nurses to upgrade their education to the BSN level
Influence on Nursing Procedures
It is expected that several units and departments will face nursing shortages and overload due to disruptions in scheduling and unavailability of some nurses who may decide to take leave of duty to complete their BSN. Additionally, some nurses with an advanced degree or diploma program may decide to leave the facility due to the educational requirement, leading to a strain on available human resources.
However, once the regulatory requirement is fully implemented, nurses will be able to provide superior patient care due to their expanded knowledge, in theory, health practices, and research. Available literature demonstrates that, while the associate program provides nurses with technological competencies needed to provide care in healthcare contexts, a BSN certification broadens their knowledge and competence in creative decision-making, ethical decision-making, critical thinking and reflection, as well as managerial and leadership skills that are fundamental in dealing with diverse and multicultural work settings and patient populations (Vernon et al., 2011).
Influence on Patient Care
Studies demonstrate that there is a direct relationship between higher levels of nursing education (BSN or higher) and improved patient care outcomes such as satisfaction with care and patient safety, minimal medication errors, and significantly reduced length of stay in hospitals (Blignaut, Coetzee, & Klopper, 2014). Although the regulatory requirement may inconvenience patients in the short-term due to projected nursing shortages, the long-term effects associated with enhanced patient care outcomes provide an additional justification for implementation.
Implementation of Change
The office of the Chief Nursing Officer will collaborate with the Human Resource (HR) department to identify nurses with an associate degree or diploma program. Once identified, a meeting will be held with the affected parties to educate them on the new regulatory standard and provide responses to their queries. A rotational program will be used to assign affected nurses to available time slots and resources so that they attend to their educational needs on a quota basis. This will be done to prevent a situation where the facility may face severe nursing shortages due to the high number of nurses enrolled in the BSN program.
The facility may also decide to recruit additional nurses to ensure that service providers will not be inhibited by the regulatory requirement. This is in the realization of the fact that the facility has a high number of associate degree nurses, who will be required to enroll in the BSN program. The HR department will also be requested to actualize the requirement that new nurses should only be recruited into the facility if they possess a BSN or a baccalaureate degree as the minimum educational requirement. Those who feel that they are not ready to upgrade to a BSN due to personal reasons will be requested to follow other career pathways so that the facility can comply with the standard in six years.
Closing Remarks
This memo has provided important information about the intended change in educational requirements for nurses in Kendall Regional Medical Center. The memo has also illuminated how the regulatory requirement is expected to affect nursing procedures and patient care outcomes. Affected nurses are required to abide by the directions provided in this memo to ensure a smooth transition.
References
Blignaut, A.J., Coetzee, S.K., & Klopper, H.C. (2014). Nurse qualifications and perceptions of patient safety and quality of care in South Africa. Nursing & Health Sciences, 16, 224-231. DOI: 10.1111/nhs.12091
Dykema, S.L. (2014). Transformation of America’s health care system: Implications for professional direct-care nurses. MEDSURG Nursing, 23(1), 61-66.
Grant, M. (2014). Regulatory requirements: A necessary evil or a way to highlight the essence of good nursing care? Clinical Journal of Oncology Nursing, 18, 265-266. DOI: 10.1188/14.CJON.265-266
Jones, D. (2015). California collaborative model for nursing education: Building a higher-educated nursing workforce. Nursing Economic$, 33, 335-341.
Robert, S.J., & Glod, C. (2013). Faculty roles: Dilemmas for the future of nursing education. Nursing Forum, 48, 99-105. DOI: 10.1111/nuf.12018
Sarver, W., Cichra, N., & Kline, M. (2015). Perceived benefits, motivators, and barriers to advancing nurse education: Removing barriers to improving success. Nursing Education Perspectives, 36, 153-156. DOI: 10.5480/14-1407
Vernon, R., Chiarella, M., & Papps, E. (2011). Confidence in competence: Legislation and nursing in New Zealand. International Nursing Review, 58(1), 103-108. DOI: 10.1111/j.1466-7657.2010.00853.x