A national survey of nursing education and practice of newly licensed nurses.

摘要

The Institute of Medicine recommended establishing evidence-based teaching methods and curricula in health professions' education to meet the needs of the changing healthcare system. In an attempt to provide evidence-based information for nursing education, this study was designed to identify educational elements that best prepare nurses for practice. The study employed a two-tiered survey process for collecting and combining data from programs of nursing education and the graduates of those programs. Administrators of 410 nursing programs responded to questions related to elements of education in their programs (response rate = 51%), whereas 7,497 RN (76.5%) and LPN (23.5%) graduates of respondent programs answered questions related to the adequacy of educational preparation for practice, difficulty with current client care assignments, and other professional and practice issues (response rate = 45.4%). The majority of the nurses reported that their education had adequately prepared them to perform many, but not all, essential areas of the nursing functions examined. Nearly 20% of the RNs and 18% of the LPNs reported having difficulty with client care assignments. Inadequate preparation of several nursing functions were identified as predictive of difficulty with patient care assignments. These areas include working effectively within the healthcare team, administering medications to groups of patients, analyzing multiple types of data when making client-related decisions, delegating tasks to others, and understanding the pathophysiology underlying a client's conditions. In addition, it was found that the graduates were more likely to feel adequately prepared when nursing programs taught them use of information technology and evidence-based practice; integrated pathophysiology and critical thinking throughout the curriculum; taught content related to the care of client populations as independent courses; and had a higher percentage of faculty teaching both didactic and clinical components of the curriculum. The findings of this study are significant in broadening our understanding of the relationships between educational elements and preparedness of new nurses for practice.