Can a BSN or MSN Improve Outcomes for Elderly Patients

Can a BSN or MSN Improve Outcomes for Elderly Patients?

Can a BSN or MSN Improve Outcomes for Elderly Patients?

Since the baby boomers began turning 65 in 2011, the number of older adults in the U.S. has increased dramatically. It’s expected that 70 million Americans will be over age 65 and 8.5 million will be over age 85 by 2030. As life expectancy increases, the oldest Americans (aged 85 years or more) have become the fastest growing group in the United States.

Because older adulthood is fluid and finds individuals transitioning from one state, activity or place to another, continuity of care is essential. The older adults’ immediate and long-term needs converge as they experience changes in health status, environment, financial resources and levels of independence and functioning. When transitions are poorly managed, older adults experience vulnerability and exacerbations of chronic health conditions.

The growing elderly population has an increasing need for healthcare services, and relies on these services far more than other segments of the population. More than three-quarters of adults over age 65 have been diagnosed with at least one chronic medical condition requiring ongoing care and management. The U.S. is facing a critical healthcare issue due to limited numbers of health care professionals with the knowledge and skill to sufficiently care for the growing geriatric population.

Education Required for Efficient Care of the Elderly

The National League for Nursing posits there is an immediate need to transform nursing education in ways that better prepare students to advance the health of America’s elderly population. As noted by Jennie Chin Hansen, RN, MS, FAAN, and CEO of the American Geriatrics Society and the past president of both AARP and the American Society on Aging, “It’s quite ironic that nursing programs have much more content on pediatrics or obstetrics—clearly needed in the curricula — but so little on complex care and geriatrics, given changing demographics and the fact that the nation spends 75 percent of its health care dollars on chronic disease. Providers assume that they are prepared to work with older adults. What they do not realize is that people’s conditions change as they age.”

Healthcare reform requires new methods for delivering care to chronically ill individuals with a greater emphasis on health promotion and disease prevention. Nurses must be familiar with the research, care coordination, outcomes management, risk assessment and quality improvement. To provide high-quality care for the aging population, nurses must display competencies in evidence-based practice, health policy, system improvement, leadership, teamwork and collaboration.

Higher levels of nursing education and training are necessary for the U.S. healthcare system to adequately respond to increasing demands. BSN- and MSN-prepared nurses are equipped to use a systems approach in addressing outcomes related to disparities that preclude quality care.

Baccalaureate Programs

Nurses who have earned a BSN are prized for their skills in critical thinking, leadership, case management and health promotion. Baccalaureate nursing programs incorporate the coursework taught in associate degree programs with more in-depth coursework aimed at enhancing professional development, preparing nurses for a broader scope of practice and providing nurses with a better understanding of the cultural, social, political and economic issues that affect patients and impact healthcare delivery.

The American Association of Colleges of Nursing emphasizes the need for coursework and clinical experiences that prepare graduates to provide care across the lifespan, especially those changes due to aging. These core values, competencies, and knowledge are vital in ensuring accessible, quality nursing care for the growing geriatric population.

Most American nurses (except for those working in pediatrics or labor and delivery) are geriatric nurses by default as this population seeks health care services in a wide variety of settings. Sadly, most nursing education programs offer little preparation in gerontological care. In 2005, the Hartford Institute for Geriatric Nursing found that only one-third of baccalaureate programs include a course in gerontological nursing. Fortunately, Spring Arbor University’s RN-BSN program requires an entire course with a gerontology focus.

Master of Nursing – Nurse Practitioner Programs

Demand is growing for advanced practice RNs whose post-graduate work prepares them for licensed independent practice delivering both primary and acute care to patients of all ages. As the Institute of Medicine’s Future of Nursing report states, “A more educated nursing workforce would be better equipped to meet these demands.” There is currently a shortage of primary care providers (PCPs) in the United States; nurses trained at the graduate level are expected to help fill this gap. Nurse practitioners (NPs) are the fastest-growing group of PCPs.

“There are not enough health providers, nurses included, who either specialize in geriatric care or who possess the necessary competency of geriatrics knowledge in their practice,” says Chin Hansen. Advanced practice nursing programs are not keeping up with producing graduates sufficiently prepared to meet the needs of the aging population. Some programs, such as the MSN-Nurse Practitioner program at Spring Arbor University trains graduates to meet these needs by offering courses focused on health promotion, disease prevention and complex problems in older adults.

Nurse Education Level and Its Link to Patient Outcomes

Numerous studies have shed light on the key role educated nurses play in the delivery of safe patient care. Research has demonstrated a relationship between a higher nursing education level and positive patient outcomes. When a facility employs a greater number of nurses with baccalaureate degrees, there is a lower rate of mortality, decubitus ulcers, failure-to-rescue and postoperative deep vein thrombosis or pulmonary embolism (all of which impact the older patient). Higher numbers of BSN-prepared nurses are also linked to a patient’s shorter length of stay.

Today’s nurses must possess a solid understanding of the issues and complex needs of older adults in order to effectively care for the aging population. Completing a BSN or MSN program is the best way to gain the skills and knowledge proven to improve patient outcomes. Programs providing courses focused on the care of the older patient will make any nurse an invaluable member of the healthcare team.

References

American Association of Colleges of Nursing (2001). Older adults: Recommended baccalaureate competencies and curricular guidelines for geriatric nursing care. Retrieved from http://www.aacn.nche.edu/publications/order-form/geriatric-competencies

American Association of Colleges of Nursing (2014). The impact of education on nursing practice [Fact Sheet]. Retrieved from http://www.aacn.nche.edu/media-relations/EdImpact.pdf

Bennett, J., and Flaherty-Robb, M., (2003). Issues affecting the health of older citizens: meeting the challenge. Online Journal of Issues in Nursing, 8(2). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume82003/No2May2003/OlderCitizensHealthIssues.html

Himes, C. L. (2002). Elderly Americans. Population Bulletin: A Publication of the Population Reference Bureau, 56(40). Retrieved from Retrieved from http://www.prb.org/Source/ACFD30.pdf

Institute of Medicine (2008). Retooling for an aging America: Building the health care workforce.  

Washington, DC: The National Academies Press. Retrieved from https://www.nap.edu/read/12089/chapter/1

Institute of Medicine (2010). The future of nursing: leading change, advancing health. Washington, DC: The National Academies Press. Retrieved from http://nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Report%20Brief.pdf

National League for Nursing (2011). Caring for older adults: A living document from the National League for Nursing. Retrieved from http://www.nln.org/docs/default-source/about/nln-vision-series-%28position-statements%29/nlnvision_2.pdf?sfvrsn=4

 

Robert Wood Johnson Foundation (2012, February 27). United States in search of nurses with geriatrics training. Retrieved from http://www.rwjf.org/en/library/articles-and-news/2012/02/united-states-in-search-of-nurses-with-geriatrics-training.html

Robert Wood Johnson Foundation (2013). The case for academic progression: Why nurses should advance their education and the strategies that make this feasible. Charting Nursing’s Future: Reports on Policies that Can Transform Patient Care, 21. Retrieved from http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2013/rwjf407597

Tri-Council for Nursing (2010). Tri-Council for Nursing issues new consensus policy statement on the educational advancement of registered nurses. Retrieved from http://www.aacn.nche.edu/education-resources/TricouncilEdStatement.pdf

 

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