By Jennifer Thew
While quality and safety measures are key to delivering excellent nursing care, new graduate nurses are not always adequately prepared in these areas, reports a new study by researchers at NYU Rory Meyers College of Nursing.
Educational preparation appears to be tied quality and safety competencies. The study found there is a growing gap in preparedness in quality and safety competencies between new nurses with associate and bachelor’s degrees. Nurses with BSN degrees report they are “very prepared” in more quality and safety measures than their ADN peers.
“Understanding the mechanisms influencing the association between educational level of nurses and patient outcomes is important because it provides an opportunity to intervene through changes in accreditation, licensing, and curriculum,” Maja Djukic, PhD, RN, associate professor at NYU Meyers and the study’s lead author, says in a news release.
Nurses With BSNs More Prepared
For the study, the researchers examined quality and safety preparedness in two groups of new nurses who graduated with either associate or bachelor’s degrees in 2007 to 2008 and 2014 to 2015. They surveyed more than a thousand new nurses (324 graduated between 2007 to 2008 and 803 graduated between 2014 to 2015).
The nurses were asked how prepared they felt about different quality improvement and safety topics. The responses of nurses with ADNs and BSNs were analyzed for differences.
There were significant improvements across key quality and safety competencies for new nurses from 2007 to 2015, however, the number of preparedness gaps between BSN and ADN graduates more than doubled during this time.
In the 2007 to 2008 cohort, nurses with BSNs reported being significantly better prepared than those with ADNs five of 16 topics:
- Evidence-based practice
- Data analysis
- Use of quality improvement data analysis and project monitoring tools
- Measuring resulting changes from implemented improvements
- Repeating four quality improvement steps until the desired outcome is achieved
Of the 2014 to 2015 graduates, those with BSNs reported being significantly better prepared than those with ADNs in 12 of 16 topics:
- The same five topics as the earlier cohort
- Data collection
- Project implementation
- Measuring current performance
- Assessing gaps in current practice
- Applying tools and methods to improve performance
- Monitoring sustainability of changes
How to Affect Change
“The evidence linking better outcomes to a higher percentage of baccalaureate-prepared nurses has been growing. However, our data reveal a potential underlying mechanism—the quality and safety education gap—which might be influencing the relationship between more education and better care,” Djukic, says.
Laws and organizational policies encouraging or requiring bachelor’s degrees for all nurses could close quality and safety education gaps, note the researchers.
New York was recently the first state to pass a law, often called the BSN in 10, requiring new nurses to obtain their bachelor’s degree within 10 years of initial licensure.
Additionally, nurse leaders and employers can affect change by:
- Preferentially hiring nurses with BSNs
- Requiring a percentage of the nurse workforce to have BSNs
- Requiring nurses with ADNs to obtain a bachelor’s degree within a certain timeframe as a condition of maintaining employment