Choosing fewer medication errors and positive outcomes

Choosing a career in nursing can be very rewarding. There are a few academic choices to choose from. There are different educational levels. These levels include an Associate (ADN), Baccalaureate (BSN) or Master degree (MSN) program. All paths require passing the NCLEX examination. However, earning an ADN, BSN or MSN leads to different specialties. The quality of patient care depends on nurses being well educated. “Research has shown that lower mortality rates, fewer medication errors and positive outcomes are linked to nurses prepared at the baccalaureate and graduate degree levels”.
The ADN curriculum consists of basic nursing courses such as anatomy and microbiology but it is a primarily a technical degree that focuses on teaching students the practicalities of nursing. The ADN program offers a foundation in nursing. This allows nurses to perform entry level positions. The curriculum consists of two years of classes focused on basic training. ADN and BSN graduates are both registered nurses. As registered nurses, those with their ADN or their BSN work side-by-side. They administer care, update medical charts and monitor patients’ symptoms together. Nurses that have a BSN are holding more leadership or managerial positions.
However, nurses with their BSN are sometimes tasked with a greater variety of duties than nurses with their ADN. The BSN also can open doors for leadership and management positions. Some nursing specialties, like public health, nurse education and nurse research also require a BSN. Baccalaureate nursing practice incorporates the roles of assessing, critical thinking, communicating, providing care, teaching and leading. More education also incorporates public health, management and leadership, nursing research and physical and social sciences. These additional courses provide students with more professional development and a heightened understanding of the issues affecting patient care and healthcare delivery. This typically follows the metaparadigm of nursing. Focus is on the entire patient including but not limited to their environment as well as theories. The BSN nurse is trained to address each patient illness based on theoretical knowledge. Having a BSN versus AND opens more opportunities in management and leadership, often supervision of other nurses. The quality of nursing does not depend on the level or degree of training. However nurses that hold a BSN are trained in conceptual thinking. In March 2005, the American Organization of Nurse Executive (AONE) released a statement calling for all registered nurses to be educated in baccalaureate programs in an effort to adequately prepare clinicians for their challenging and complex roles. AONE’s statement titled Practice and education Partnership for the future represents the view of nursing’s practice leaders and a desire to create a more highly educated nursing workforce in the interest of improving patient safety and providing enhanced nursing care.
When discharging a patient home the ADN nurse plans the patient’s discharge and discusses medications. The same nurse also assists with setting up transportation home and making sure that his/her medication prescriptions are called in to the correct pharmacy. The patient was happy to be discharged but was unsure as to this nurse did not take in consideration what caused their admission. This certain patient was on a fixed income and lived alone. They were unable to drive due neuropathy related to diabetes. The patient hemoglobin A1C was very high. After further evaluation of the patient the BSN nurse began to speak with the patient and give information in their follow up appointment. Upon further discussion the patient revealed certain aspects of their daily care. The patient’s low income along with poor choice of foods gave further insight about why their blood sugar remained at such high levels. The patient was unable prepare and cook healthy meals due to their illness. The patient could not afford healthy snacks and instead chose cheap snacks high in carbohydrates and high fructose sugar. The nurse then spoke with the case manager and social worker to create a plan of care. Prior to discharge the treatment team met and solutions were out in place. Transportation was set up for appointments. The patient was also admitted to a home health agency to ensure the patient had skilled nursing care while home. The patient was also set up with meals on wheels to make sure that they had healthy food choices.

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