NRS 430 Topic 1 Assignment: Contemporary Nursing Practice

NRS 430 Topic 1: Contemporary Nursing Practice
Nursing remains a core part of healthcare delivery since the first nurse, Florence Nightingale, began the profession over two centuries ago. Started as part of caregiving, nursing is today one of the most critical professionals in healthcare and continues to evolve as nurses become more involved in care provision at the frontline as demonstrated at the height of the COVID-19 pandemic. Today, nurses prepare to offer care through advanced education and training. From associate degree nurses (ADNs) to BSN-prepared nurses and even those with terminal degrees like PhD., the contemporary nurse is well-positioned to offer quality patient care and is transforming healthcare (Snoswell et al., 2020). The purpose of this paper is to discuss the transformation of nursing practice and its position today in healthcare delivery.

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Evolution of Nursing Practice & Effects on the Scope of Practice
Nursing practice has evolved and transformed in the last six decades compared to the other centuries. Today, present nurses specialize and are expected to attain higher levels of education and training to meet the changing patient needs. More fundamentally, they are expected to possess key skills and competencies like critical skills and analytical capabilities. Florence Nightingale founded the modern nursing practice in the mid-19th. At the time, the public opposed the idea of women nursing strangers but Nightingale considered nursing as an extraordinary chance for women. She believed that women could utilize not just their education but also scientific knowledge to enhance patient care as they attain personal independence (Graebe et al., 2019). However, wars like the Crimean War and later on the Civil War changed public perception of nursing as women made a significant impact by caring for wounded soldiers.
Based on newfound public support due to the indisputable contributions to healthcare, the profession would develop quickly over time leading to the establishment of training programs at colleges and universities. By 1960, there were over 170 college nursing programs in the United States. Today, over 870 schools exist in the country offering nursing education programs at undergraduate, graduate, and postgraduate levels (McMenamin et al., 2019). The Institute of Medicine (IOM) in its report in 2010 provided a framework to enhance the nursing profession by increasing nurses with bachelor’s degree. Consequently, the American Association of Colleges of Nursing (AACN) has set the BSN as the standard for all registered nurses. Again, there is a greater emphasis on academic progression for nurses to meet the high patient demand leading to changes in the scope of practice.
The changes in nursing practice affect the scope of practice and the approach to treating individuals. Nurses specialize in different areas and attain competencies that allow them to customize care plans based on individual patients’ needs and complications. For instance, the integration of evidence-based practice and culturally competent care has altered how nurses treat individuals through the patient-centered care model. Nurses should have sufficient training and competencies in their practice areas to deliver better and patient-centered care.
Differentiated Practice Competencies Between ADN and BSN Education
The Bachelor of Science in Nursing (BSN) prepared nurses are considered professional nurses compared to associate-degree (ADN) trained technical nurses. Again, ADNs are trained primarily on clinical skills but the BSN-prepared nurses focus on more aspects like nursing research, clinical competencies, and skills that include analytical and critical thinking skills, and also managerial components as well as cultural component (Salas et al., 2018). However, both qualification offer nurses skills that focus on meeting accepted and standard patient care. Another difference is that BSN-level-prepared nurses focus more on primary care through disease prevention and patient education, research and advocacy, community health, and implementing evidence-based practice. They also leverage data, informatics and generate better solutions to care provision for effective patient outcomes as part of their scope. The scope of practice for ADNs includes nursing care on aspects like documenting patients’ medical history, recording and noting patient symptoms, having knowledge of using simple medical equipment and providing patient education on various disease conditions, and assisting physicians.
Differences in Patient Care Coordination
BSN-prepared nurses handle or approach nursing care and decision-making differently from ADNs. For example, in the case of a patient presenting with congestive heart failure (CHF) and requiring blood transfusion, the BSN will evaluate the vital signs to ensure that there are in normal ranges and the lungs produce clear bilateral sounds. However, towards the end of the blood transfusion, the nurse may notice that oxygen saturation is dropping to below 95% and chest sounds moist. The ADN-prepared nurse may place the patient on a 21/min nasal cannula but the saturations continue to decline to 90%. However, since the BSN-prepared nurse thinks outside the box, she or he will conclude that the patient has an overload of fluids because of her condition (CHF) (Snoswell et al., 2020). Therefore, the BSN-prepared nurse will place the patient on a diuretic procedure to remove excess fluids but the ADN is likely to increase oxygen to 31/min to have the saturation above 95%. As such, BSN-prepared nurses use scientific evidence and best practices in making effective clinical decisions but associate degree nurses may not possess such in-depth knowledge to make better decisions.
Importance of Using Evidence-Based Practice in Nursing Care
Evidence-based practice entails delivering care founded on research studies and working in a host of settings through clinical trials. Evidence-based practice (EBP) allows healthcare facilities to offer reliable and high-quality patient care. EBP also enables nurses to improve their skills and competencies and process information for effective care delivery. The RN to BSN curriculum focuses on research and clinical expertise which are core components of evidence-based practice (Thielmann et al., 2019). Through EBP, nurses focus on improving care quality and enhancing population health for different groups and individuals. BSN-prepared nurses get sufficient training in leadership, management, and effective communication to implement EBP.
Communication and Collaboration in Interdisciplinary Teams
Nurses should communicate effectively and collaborate with other healthcare professionals to deliver quality care. Imperatively, nurses use a range of approaches in communicating and collaborating while in interdisciplinary teams. These include electronic means like emails, text messages, the use of electronic health records (EHRs), and verbal through exchanging and sharing thoughts, opinions, and information (Walton et al., 2019). They also write and make presentations before other professionals like physicians and implement EBP interventions to improve the quality of care.
Conclusion
The nursing profession and practice have evolved and continue to transform to deliver better patient care and meet the rising care demands. Nurses are a core part of the healthcare delivery system with BSN-prepared nurses demonstrating increased competencies and skills to deliver better care. As such, the transformation in the health sector implores nurses to get advanced education for effective specialization to offer better patient-centered care in their practice settings.
References
Graebe, J., & Chappell, K. (2019). Looking back and leaping forward—a reflection on the
evolution of nursing continuing professional development credentialing. The Journal of Continuing Education in Nursing, 50(12), 531-533. DOI: 10.3928/00220124-20191115-01
McMenamin, A., Sun, C., Prufeta, P., & Raso, R. (2019). The evolution of evidence-based
practice. Nursing Management, 50(9), 14-19. DOI: 10.1097/01.NUMA.0000579000. 09987.b0.
Salas, E., Zajac, S., & Marlow, S. L. (2018). Transforming health care one team at a time: ten
observations and the trail ahead. Group & Organization Management, 43(3), 357-381. https://doi.org/10.1177/1059601118756554
Snoswell, C. L., Taylor, M. L., Comans, T. A., Smith, A. C., Gray, L. C., & Caffery, L. J.
(2020). Determining if telehealth can reduce health system costs Scoping review. Journal of Medical Internet Research, 22(10), e17298. https://doi.org/10.2196/17298
Thielmann, B., Parker, K., Post, J., & Abraham, S. (2019). Factors influencing nurses’
perceptions of the Baccalaureate Degree in Nursing as a minimum requirement for Professional Practice. Nursing Education Perspectives, 40 (1), 25-29. DOI: 10.1097/01.NEP.0000000000000391.
Verot, E., Denois, V. R., & Chauvin, F. (2021). Current Perceptions of cancer nurses in France
about their role and the evolution of nursing practices: Findings and perspectives. Social Science & Medicine, 277, 113896. DOI: 10.1016/j.socscimed.2021.113896.
Walton, V., Hogden, A., Long, J. C., Johnson, J. K., & Greenfield, D. (2019). How do inter-
professional healthcare teams perceive the benefits and challenges of interdisciplinary ward rounds. Journal of Multidisciplinary Healthcare, 12, 1023–1032. https://doi.org/10.2147/JMDH.S226330

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Assessment Description

The field of nursing has changed over time. In a 750-1,000-word paper, discuss nursing practice today by addressing the following:

Explain how nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
Compare the differentiated practice competencies between an associate (ADN) and baccalaureate (BSN) education in nursing. Explain how scope of practice changes between an associate and baccalaureate nurse.
Identify a specific client care situation and describe how nursing care, or approaches to decision making, differ between the BSNâ€Âprepared nurse and the ADN nurse.
Discuss the significance of applying evidenceâ€Âbased practice to nursing care and explain how the academic preparation of the RNâ€ÂBSN nurse supports its application.
Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective client outcomes.
Review the “APA Formatting Tutorial,” located in Class Resources. Utilize the APA paper template and the APA Style Guide, located in the Student Success Center, to ensure correct paper formatting when preparing applicable assignments.

You are required to cite a minimum of three sources to complete this assignment. Sources must be appropriate for the assignment and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

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Contemporary Nursing Practice – Rubric
Rubric Criteria
Total
150 points
Criterion

1. Unsatisfactory

2. Insufficient

3. Approaching

4. Acceptable

5. Target

Nursing Practice Changes, Scope of Practice, and Approach to Client Care

0 points

The essay does not provide an explanation of how nursing practice has changed over time, information about how these changes have impacted the scope of practice, or the approach to treating the individual.

11.25 points

The essay does not clearly explain how nursing practice has changed over time and is lacking information about how these changes have impacted the scope of practice and the approach to treating the individual.

11.85 points

The essay provides a basic explanation of how nursing practice has changed over time, including how these changes have impacted the scope of practice and the approach to treating the individual.

13.35 points

The essay clearly explains how nursing practice has changed over time, including how these changes have impacted the scope of practice and the approach to treating the individual.

15 points

The essay comprehensively explains how nursing practice has changed over time, including how these changes have impacted the scope of practice and the approach to treating the individual.

Comparison of Differentiated Practice Competencies and Scope of Practice

0 points

The comparison of the differentiated practice competencies between the ADN and BSN is not included. No explanation is provided for the scope of practice changes between an associate- and baccalaureate-prepared nurse.

16.88 points

The comparison of the differentiated practice competencies between the ADN and BSN is unclear. The explanation for how the scope of practice changes between an associate- and baccalaureate-prepared nurse is incomplete.

17.78 points

The comparison of the differentiated practice competencies between the ADN and BSN is included in a general manner. A basic explanation for how the scope of practice changes between an associate- and baccalaureate-prepared nurse is provided.

20.03 points

The comparison of the differentiated practice competencies between the ADN and BSN is clear. A clear explanation for how the scope of practice changes between an associate- and baccalaureate-prepared nurse is provided.

22.5 points

The comparison of the differentiated practice competencies between the ADN and BSN is comprehensive. A detailed and well thought out explanation for how the scope of practice changes between an associate- and baccalaureate-prepared nurse is provided.

Nursing Care or Approaches to Decision Making Regarding Client Care Differences

0 points

A specific client care situation is not included. There is no description of how nursing care or approaches to decision making differ between the BSN-prepared nurse and the ADN nurse.

16.88 points

A specific client care situation is not clearly identified, and a description of how nursing care or approaches to decision making differ between the BSN-prepared nurse and the ADN nurse is incomplete.

17.78 points

A specific client care situation is identified, and a basic description of how nursing care or approaches to decision making differ between the BSN-prepared nurse and the ADN nurse is provided.

20.03 points

A specific client care situation is identified, and a clear description of how nursing care or approaches to decision making differ between the BSN-prepared nurse and the ADN nurse is provided.

22.5 points

A specific client care situation is identified, and a comprehensive description of how nursing care or approaches to decision making differ between the BSN-prepared nurse and the ADN nurse is provided.

The Significance of Applying Evidence-Based Practice to Nursing Care and the RN-BSN-Prepared Nurse

0 points

The discussion about the significance of applying evidence-based practice to nursing care and the explanation of how the academic preparation of the RN-BSN nurse supports its application are not included.

16.88 points

The discussion about the significance of applying evidence-based practice to nursing care is unclear, and the explanation of how the academic preparation of the RN-BSN nurse supports its application is incomplete.

17.78 points

There is a basic discussion about the significance of applying evidence-based practice to nursing care and a general explanation of how the academic preparation of the RN-BSN nurse supports its application.

20.03 points

There is a clear discussion about the significance of applying evidence-based practice to nursing care and a concise explanation of how the academic preparation of the RN-BSN nurse supports its application.

22.5 points

There is a comprehensive discussion about the significance of applying evidence-based practice to nursing care and a detailed explanation of how the academic preparation of the RN-BSN nurse supports its application.

Nursing Communication and Collaboration with Interdisciplinary Teams to Support Client Outcomes

0 points

The essay does not include a discussion about how nurses today communicate or collaborate with interdisciplinary teams. An explanation of how this would support safer and more effective client outcomes is not included.

16.88 points

The essay does not clearly discuss how nurses today communicate and collaborate with interdisciplinary teams. An explanation of how this would support safer and more effective client outcomes is incomplete.

17.78 points

The essay includes a basic discussion about how nurses today communicate and collaborate with interdisciplinary teams. A general explanation of how this would support safer and more effective client outcomes is included.

20.03 points

The essay includes a clear discussion about how nurses today communicate and collaborate with interdisciplinary teams. A concise explanation of how this would support safer and more effective client outcomes is included.

22.5 points

The essay includes a comprehensive discussion about how nurses today communicate and collaborate with interdisciplinary teams. A comprehensive explanation of how this would support safer and more effective client outcomes is included.

Thesis, Position, or Purpose

Communicates reason for writing and demonstrates awareness of audience.

0 points

The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.

7.88 points

The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.

8.3 points

The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is demonstrated.

9.35 points

The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.

10.5 points

The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a specific audience.

Development, Structure, and Conclusion

Advances position or purpose throughout writing; conclusion aligns to and evolves from development.

0 points

No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.

7.88 points

Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.

8.3 points

The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.

9.35 points

The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and plausible conclusion aligns to the development of the purpose.

10.5 points

The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of the purpose.

Evidence

Selects and integrates evidence to support and advance position/purpose; considers other perspectives.

0 points

Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.

6.75 points

Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.

7.11 points

Relevant evidence that includes other perspectives is used.

8.01 points

Specific and appropriate evidence is included. Other perspectives are integrated.

9 points

Comprehensive and compelling evidence is included. Multiple other perspectives are integrated effectively.

Mechanics of Writing

Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.

0 points

Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.

6.75 points

Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.

7.11 points

Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.

8.01 points

Few mechanical errors are present. Suitable language choice and sentence structure are used.

9 points

No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout.

Format/Documentation

Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc., appropriate to assignment and discipline.

0 points

Appropriate format is not used. No documentation of sources is provided.

4.5 points

Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.

4.74 points

Appropriate format and documentation are used, although there are some obvious errors.

5.34 points

Appropriate format and documentation are used with only minor errors.

6 points

No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated.