Pros and cons of evidence based practice

Pros and cons of mandatory continuing nursing education

Karen DeFilippis, Idalmis Espinosa

Lasharia Graham, Ijeoma Igbokwe

Karan Kortlander, Jessica McGillen

October 01, 2017

objectives

Discuss the pros and cons of continuing education in nursing in the following areas:

Impact on competency.

Impact on knowledge and attitudes.

Relationship to professional certification.

Relationship to ANA Scope and Standards of Practice.

Relationship to ANA Code of Ethics.

Impact on competency

Pros: Cons:

Increased personal knowledge Time

Increased use of EBP treatments Cost

Improved patient outcomes

Increased confidence

Developing and maintaining skills

Professional Networking

“Currently in many states, a nurse is determined to be competent when initially licensed and thereafter unless proven otherwise. Yet many believe this is not enough and are exploring other approaches to assure continuing competence in today’s environment where technology and practice are continually changing, new health care systems are evolving and consumers are pressing for providers who are competent” (Whittaker, Carson, & Smolenski, 2000).

“The ultimate outcomes of continuing nursing education (CNE) activities are to improve the professional practice of nursing and thereby the care that is provided by registered nurses to patients” (American Nurses Credentialing Center’, 2014)

Effective workplace learning, based on current evidence, appears to show potential to prevent errors, support health professional reflection on practice and performance, foster ongoing professional development, and sustain improved individual and organization performance outcomes.

Cost- “Continuing education can be costly. For instance, it is costly to pay employees to attend a nursing lecture or conference and to be away from the patients’ bedside. Additionally, purchasing videos or subscribing to magazines does require an associated payment. Lastly, implementing a change is costly it requires training and often new equipment. Without question, cost is a confounding variable” (Ward, 2013)

Time- This can be time away from work and family. For the employer ‘implementing a change in practice does require time, as does completing continuing education credit hours. This could mean time away from the patient which, in most instances, is frowned upon” (Ward, 2013)

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Pros of higher education in nursing

Enhance patients’ outcome.

Reduces medication errors.

Update with new trends.

Increased knowledge on technology use.

Treatment evaluation and recovery.

Enhance collaboration and networking.

Widens employment opportunities for nurses (University of Saint Mary,2017).

Higher nursing education prepares nurses to make a difference in delivering safe and effective care to patients, nurses gain the skills needed to safely administer medication while eliminating or reducing medication errors, monitoring and assessing the patient’s response to medications (University of Saint Mary, 2017). Nurses acquire proficiency on the use of new technologies because higher education programs explores the latest technology. Nurses are updated on the new trends in healthcare to keep up with patients’ changing needs. Nurses are able to effectively and proficiently coordinate patients’ care by collaborating and communicating with other health care teams, gain new knowledge through networking; nurses are exposed to seminars where they meet and interact with other healthcare professional.

Nurses are prepared to evaluate patients’ response to treatment and follow up after discharge to improve the quality of patients lives (University of Saint Mary, 2017). Nurses who have higher education certificates have more employment opportunities. Most hospitals requiring nurses to go back to school to get BSN, and preferring to hire nurses who have BSN.

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Cons and attitudes of not continuing with higher education in nursing

Limited career opportunities and positions.

Poor patient outcome.

Lack of confidence.

Limited Knowledge, competency and skills.

Lack of opportunities for collaboration.

There are several disadvantage of not pursing higher education in nursing, nurses are most times denied of a job or a position due to the level of their education. Nurses who starts as staff nurses are promoted to a higher position with experience, good performance and continuous education (College Grad, 2017). Studies have linked poor patients outcome to lack of nursing skills and knowledge; Thus to enhance patient’s safety and quality care, nurses are required to go for a higher education or study as recommended in Institute of medicine report . Higher education does not only benefit the patients but also boost the confidence of nurses. Lack of confidence decrease self-esteem, every nurses needs to believe in him/herself to work effectively and efficiently while collaborating with other health care team. Lack of education limits learning new skills and opportunity to grow in knowledge and also could hinder opportunities to fellowship or collaborate effectively with other health care professionals.

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Pros of continuing higher education related to the relationship to professional certification

Increases knowledge and quality of care in nursing practice.

Enhances nurses’ ability to compete in the job market.

Develops a nurses’ confidence and professionalism.

Defines nursing practice and attests to ongoing qualifications (Brunt).

The ANA defines certification as an achievement of exemplary nursing knowledge; therefore, continuing education promotes the above noted benefits. The question of mandatory continuing education for nurses has been brewing since the 1960s (Brunt). The National League for Nursing supports that mandatory continuing education should be required for relicensure. Currently, there are more than 68 various certifications available to nurses, and most of them require continuing education programs.

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CONS OF CONTINUING HIGHER EDUCATION RELATED TO THE RELATIONSHIP TO PROFESSIONAL CERTIFICATION

Cons include:

Education does not assure competence.

Continuing education is expensive.

Evaluation tools are ineffective and not always accurate (Brunt).

Continuing education does not show evidence of better patient-care outcomes (Eustace, 2001).

Those opposed to mandatory continuing education maintain that as professionals, nurses are personally responsible to identify and acquire appropriate education (Brunt). Some have pointed out that mandatory continuing education does not necessarily address advanced practice nurses, or those in administration, research, and education. Others argue that it may be difficult to obtain continuing education in remote areas, and that most healthcare practitioners already take part in continuing education on their own (Brunt).

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PROS TO CONTINUING EDUCATION RELATED TO ANA SCOPE AND STANDARDS OF PRACTICE

Improves quality of patient care

Expands knowledge and contribute to career growth

Ensures competency in practice

Providing best evidence based nursing care

The scope of practice is defined by the , “who”, “what”, “where”, “when”, “why”, and “how” of nursing practice. The practice of nursing requires specialized knowledge, skills and independent decision making. Every nurse should be knowledgeable and up to date with the latest evidence based practice in order to provide the best care to their patients. With higher education nurses are able to take on leadership roles. Leadership roles are important to help lead change to transform health care, and for “public, private, and governmental health care decision makers at every level” to “include representation from nursing on boards (Campaign for Action, 2014).

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CONS TO CONTINUING EDUCATION RELATED TO ANA SCOPE AND STANDARDS OF CARE

Cost of Tuition

Balancing Personal life

Lack of appropriate knowledge on the subject

Lack of a guarantee that the continuing education standards will assist the nurse in the nursing field

The cost of going back to school can be very expensive. There are programs to help pay for some of the cost for tuition, but you still are responsible for a portion of the tuition. Some may not even know about the different programs to help you pay for school. They may be paying out of pocket. And we all know once we graduate, loan repayment will be waiting on us.

Another disadvantage of returning to school is balancing personal life. Some of us work full time jobs and have kids like myself. I also have a part time job as well. It can become very difficult squeezing classes in on top of our already busy schedule. Sometimes I don’t get a chance to do my work until the last minute when its due. I know there were plenty of times I felt like just giving up on classes because I don’t have enough time in a day to get every thing done. Then I start thinking of all the benefits of higher education

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CODE OF ETHICS provision 5 related to Continuing Education

As outlined by the ANA, provision 5 includes that nurses owe the same duties to self as others, this includes responsibility to preserve integrity and safety, maintain competence, and to continue personal professional growth (Fowler and American Nurse Association, 2010).

PROS

Fair and equal treatment

Safe patient care

Be competent

Be educated to provide the best care

Grow professional and personally

Expand career knowledge and skills

Integrity

Builds confidence

Helps guide better decision making

Creates trust

Extends positive influence

CONS

Personal and professional growth requires a time commitment

Being competent and advancing can include a financial commitment

Growing pains

Feeling out of comfort zone

The Code of Ethics is a public expression of what a nurse commits oneself to when entering the workforce as a nurse. The Code expresses values, duties, and commitments that all nurses will strive for (ANA, 2010). There are many pros and a few cons to nurses agreeing to follow the Code of Ethics. The pros mentioned above can greatly outweigh the cons. As nurses we are here to serve people, we extend ourselves to care for others. In caring for others we must also care for our self in the process. The ANA outlines for professional growth a nurse is responsible for “continued reading, study, observation, and investigation” (2010). All of the above are outlined by the ANA.

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CODE OF ETHICS PROVISION 7 RELATED TO CONTINING EDUCATION

Fowler and the American Nurses Association defined provision 7 as, a nurses participation in the advancement of the profession through contributions to practice, education, administration, and knowledge development (2010).

PROS

Advancements

In education

In practices of care

In administration

Knowledge

CONS

Having the need to want advancement

Time commitment

Possible financial commitment

Growing pains

Being pushed out of your comfort zone

Nurses are the forefront of advancement for the medical field. We hold many positions from floor nursing, administration and educators within the health care system. For the field of nursing and nurses to continue to grow and advance we all must pledge to participate in advancing the profession with education, and the search of knowledge. Examples of ways that nursing has advanced from the past is nurses now have advanced degrees such as: Master and doctoral level educations and also Nurse Practitioners. The ANA provides specifics on where nurses can advance the profession; be involved in healthcare policy, develop, maintain and implement professional standards in clinical practice, administration and education practices, and apply knowledge development, dissemination and application to practice (2010). As nurses the ANA Code of Ethics provides a pathway to things that will improve nursing practice as a whole.

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CODE OF ETHICS

CONCLUSION

References

American Nurses Credentialing Center. (2014). The Importance of Evaluating the Impact of Continuing Nursing Education on Outcomes:Professional Nursing Practice and Patient Care. Retrieved from http://www.nurse.credentialing.org/Accreditation/

Fowler, M. D., & American Nurses Association. (2010). Guide to the code of ethics for nurses: Interpretation and application. Silver Spring, MD: American Nurses Association.

Ward, J. (2013, January 23). The Pros and Cons of Getting Nursing CEUs. Retrieved from Nurse Together: http://

www.nursetogether.com/pros-and-cons-getting-nursing-ceus

Whittaker, S., Carson , W., & Smolenski, M. C. (2000, September). Assuring Continued Competence - Policy Questions and Approaches: How Should the Profession Respond? Online Journal of Issues in Nursing. Retrieved from : http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/

Brunt, B. The importance of lifelong learning in managing risks. The Nursing

Risk Management Series(3). Retrieved from http://ana.nursingworld.org/mods/archive/mod311

Eustace, L. (2001). Mandatory continuing education:past, present, and future trends & issues.

The Journal of Continuing Education in Nursing 32(3).

References

Nursing: Scope and Standard of Practice. Retrieved from www.nursingworld.org

ANA Leadership – American Nurses Foundation. Retrieved from www.anfonline.org

University of Saint Mary. (2017) Higher Nursing Education and its Impact on Patient Safety. Retrieved on September 21st from http://online.stmary.edu/rn-bsn/resources/higher-nursing-education-impact-on-patient-safety

College Grad (2017) Registered nurses. Retrieved September 24th, from https://collegegrad.com/careers/registered-nurses