Healthcare facilities are making progress when it comes to implementing recommendations on nurse residency programs and academic progression from the Institute of Medicines report on the future of nursing, but barriers remain, according to two new studies.
Researchers at the George Washington University School of Public Health and Health Services in Washington, D.C., conducted the studies to examine how well hospitals and other healthcare facilities are doing regarding a call in the report to reform the nursing profession. The 2010 IOMs The Future of Nursing: Leading Change, Advancing Health report called for the nursing profession to change so it will be able to meet demands that are emerging because of health reform, new technologies and an aging population.
In the first study, Patricia Pittman, PhD, associate professor of health policy at SPHHS, and colleagues examined the degree to which healthcare employers have implemented a key IOM recommendation the goal of achieving a workforce in which 80% of RNs have a BSN by the year 2020. Nurses need more educational training to handle greater responsibilities and the increased complexity of the healthcare system, the IOM report noted. To achieve the 80% goal, the report suggested health facilities take a series of measures to encourage nurses with an associate degree to complete a BSN.
To find out how well the recommendation had been faring in the real world, Pittmans team surveyed 447 nurse executives in hospitals, nurse-led clinics and home and hospice care companies. The researchers found nearly 80% of those surveyed said their institutions preferred or required newly hired RNs to have a bachelors degree. The study also found 94% of facilities offered some level of tuition reimbursement to encourage nurses to continue their educations and complete a BSN.
However, only 25% of employers required nurses to earn a BSN within a period of time, a key part of the IOM recommendation, and only 9% offered a pay differential to nurses who complete a BSN.
If healthcare employers are serious about wanting a more highly educated workforce, the study authors conclude, they will need to adopt more forceful measures, such as requirements for degree completion and wages that reward nurses who have worked to get BSNs or advanced degrees.
The likelihood of employers adopting such hard measures any time soon, however, will at least partially be determined by the supply and demand for nurses in the marketplace, Pittman said in a news release.
The study, Healthcare Employers Policies on Nurse Education, was published in the November/December 2013 Journal of Healthcare Management
RN residency programs
The second study examines the extent to which healthcare employers are adopting nurse residency programs another key IOM recommendation. According to the report, nurse residency programs help give new RNs the skills they need on the job and help to reduce turnover. Past studies have shown between 35% and 65% of nurses change jobs within their first year of employment, a problem that increases costs for hospitals and other facilities.
Pittman and her team surveyed hospital nurse executives and found, despite the financial challenges being faced by hospitals and the increased supply of nurses resulting from the economic recession, 36.9% of hospitals already offered a nurse residency program in 2011, and only one-fifth of those received external funding to kick off or maintain such a program.
Among those hospitals without residencies, three obstacles to adoption were cited: financial constraints, taking senior staff away from other work and a shortage of faculty who can supervise new nurses as they learn best practices.
The study found hospitals with nurse residency programs also are more likely to offer other training programs.
This finding may suggest that the institutional culture at these hospitals may be putting a high value on both kinds of training, a value that appears to go beyond a simple cost savings calculation based on reduction of nurse turnover, Pittman said in the release.
The second study, Residency Programs for New Nurse Graduates: How Widespread Are They and What Are the Primary Obstacles to Further Adoption, was published in the Journal of Nursing Administration.
Both studies were funded by the Robert Wood Johnson Foundation Initiative on the Future of Nursing.
Study abstract: http://bit.ly/19mgeFQ
Journal of Healthcare Management: www.ache.org/pubs/JHM/jhm_index.cfm