-750-1000 words; double spaced

Topic 2: Scope of Practice and Differentiated Practice Competencies
Essay requirements: The field of nursing has changed over time. In a 750‐1,000 word paper, discuss nursing practice today by addressing the following:

1) Explain how the nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.
2) Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how the scope of practice changes between an associate and baccalaureate nurse.
3) Identify a patient care situation and describe how nursing care, or approaches to decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.
4) Discuss the significance of applying evidence‐based practice to nursing care and explain how the academic preparation of the RN‐BSN nurse supports its application.
5) Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes

Contemporary Nursing Practice

1) Explain how the nursing practice has changed over time and how this evolution has changed the scope of practice and the approach to treating the individual.

The nursing practice has evolved and changed in response to the objective of providing improved care and achieving better care outcomes for the patients. Patients, irrespective of their care setting, deserve to receive care that shifts away from the convenience of nursing personnel and moving towards health care centered on the unique needs of the patients. The transformation in the health care system has necessitated the roles of nurses to be revised. Legislative and policy amendments (such as the Affordable Care Act of 2010) outline how the new health care systems should be structured, and how the structured can be matched with new roles. In fact, the legislative amendments and policies are now targeted at making necessary improvements to care value, access and quality. This allows nurses to play a central role in transforming health care systems to create a value driven, high quality and more accessible environment for their patients. This is reflected in the scope of practice for nurses, which has enabled them to take on greater responsibilities (Porter-O’Grady & Malloch, 2016).  Contemporary Nursing Practice Essay Discussion Paper

2) Compare and contrast the differentiated practice competencies between an associate and baccalaureate education in nursing. Explain how the scope of practice changes between an associate and baccalaureate nurse.

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Associate’s Degree in Nursing (ADN)and Bachelor of Science in Nursing (BSN) are fundamentally different. An ADN appears easier and faster while a BSN allows the nurse to provide complex patient care. An ADN nurse offers simple nursing care services that include using simple medical equipment, working closely with physicians, educating patients on medical conditions, and recording medical history and patient symptoms. On the other hand, BSN nurses are qualified for more complex nursing care services and are typically involved in managing other nurse personnel, taking on leadership responsibilities, and completing complex procedures under the supervision of doctors. A BSN nurse is considered to offer safer care than an ADN nurse since they are better trained, ready and prepared to tackle more care responsibilities as a result of their educational experiences. In fact, a BSN nurse is highly qualified and trained to meet the patients’ nursing care needs and delivery effective and safe care. Additional reviews of their competencies reveals that BSN nurses are professional nurses while ADN nurses are technical nurses. BSN focuses on clinical skills, management, nursing research and leadership training while ADN focuses on clinical skills training. While both (BSN and ADN) prepare nurses to offer care that meets the acceptable care standards, BSN focuses more on informatics, advocacy, community health, disease prevention and research. Also, BSN requires a better understanding of the social, economic and cultural issues that influence health care delivery systems and affect patients. Overall, both ADN and BSN are targeted at teaching nursing and clinical practice competencies, while BSN goes a step further in teaching nursing informatics, nursing theory, communication, critical thinking, social sciences, public health, leadership and management competencies (Nightingale College, 2017; Slyter, 2019).

3) Identify a patient care situation and describe how nursing care, or approaches to decision‐making, differ between the BSN‐prepared nurse and the ADN nurse.

Patient care situations involving the safety of the patients will place different demands on BSN and ADN nurses. These situations would require that nurses provide care that is responsive to and respectful of individual patient values, needs and preferences while ensuring that the clinical decisions are guided by the patients. While BSN nurses are not necessarily better than ADN nurses, the complex health care climate demands advanced skills to manage complex situations, and these skills can only be provided by BSN nurses. To be more precise, an ADN nurse is prepared to delivery high patient care standards, but a BSN nurse goes a step further in managing the social, economic and cultural issues that influence health care delivery and affect the patient. Besides that, the skills that BSN nurses acquire in training enable them to communicate better with the patients and establish stronger relationships and trust, which can be translated into better care outcomes. They can assess the situation correctly and make better decisions for the patients. Also, BSN training improves medication administration, treatment evaluation and recovery, and tech proficiency as aspects of patient care (Nightingale College, 2018).

4) Discuss the significance of applying evidence‐based practice to nursing care and explain how the academic preparation of the RN‐BSN nurse supports its application.

Evidence-based practice (EBP) has much significance for nursing care as it involves conscientiously, explicitly and judiciously apply current best evidence to make nursing care decisions. It implies integrating nursing expertise with the best available clinical evidence acquired from systematic reviews of literature. EBP is targeted at improving care effectiveness and patient outcomes. Besides that, EBP promotes an inquiry attitude that always seeks to improve (Black, 2016). BSN nurses are academically prepared to support the application of EBP. The preparation occurs through including communication, critical thinking, social sciences, public health, leadership, leadership and management courses as part of the curriculum. Also, the training includes nursing informatics and theory that teaches nurses how to use new medical technology. The courses prepare BSN nurses to have a better understanding of the complex issues that affect patients and the health care environment thus allowing them to make better decisions, thus supporting the application of EBP (Nightingale College, 2017).

5) Discuss how nurses today communicate and collaborate with interdisciplinary teams and how this supports safer and more effective patient outcomes.

The understanding that effective clinical practice can only be achieved if critical information is accurately communicated highlights the importance of interdisciplinary teams. In fact, team collaboration is important for delivering effective nursing care. There is a high probability of patient safety being at risk if there is no effective communication between nurses and other members of the interdisciplinary team. That is because ineffective communication results in changes in patient status being overlooked, orders being unclear, information being misinterpreted, and critical information missing (Black, 2016). As such, there is a need for nurses to engage in communication and collaboration with other members of the interdisciplinary teams to support safer and more effective patient outcomes.

References

Black, B. (2016). Professional nursing: concepts & challenges. Elsevier Health Sciences.

Nightingale College (2017). ADN vs BSN Debate: These Are the Real Differences Between ADN and BSN Prepared Nurses. https://nightingale.edu/blog/adn-vs-bsn-differences/

Nightingale College (2018). ADN vs BSN in Patient Care and Safety Situations: Do Nurses’ Education Improve Patient Outcomes? https://nightingale.edu/blog/adn-vs-bsn-patient-outcomes/

Porter-O’Grady, T. & Malloch, K. (2016). Leadership in nursing practice: changing the landscape of healthcare (2^nd ed.). Jones & Bartlett Learning.

Slyter, K. (2019). ADN vs. BSN: Your Guide to Help You Decide on a Nursing Degree. https://www.rasmussen.edu/degrees/nursing/blog/adn-vs-bsn/. Contemporary Nursing Practice Essay Discussion Paper