REPLY1  Mackey and Bassendowski (2017) argue that the quality o

REPLY1  Mackey and Bassendowski (2017) argue that the quality of patient outcome depends on well-trained nursing personnel. Further adding that reduced mortality rates, few medical errors and positive outcomes are associated with baccalaureate and degree nursing programs. In addition, training and learning process that instills skills in healthcare providers play a very important role in optimizing quality and guarantees patient safety. There are very many reasons why nurses decide to pursue baccalaureate degrees including to obtain leadership roles in organization as well as promoting quality of patient care. According to study carried out by National Center for Biotechnology information findings concluded that hospitals with high numbers with BSN nurses have generally lower mortality and few medical errors as compared to those hospitals with few BSN nurses. The labor statistics bureau released a report showing a shortage of 3 million BSN nurses in United States (Cho, Sloane, Kim, Kim, Choi, Yoo & Aiken, 2015). Despite the fact that hospitals still believe that they will still get 80% BSN registered nurses by the end of 2020 as recommended by institute of medicine there is still a large group of registered nurses without baccalaureate education. I work in palliative care unit in our facility where we have only one BSN trained nurse with many ADN nurses thus making it difficult to minimize medical errors. In conclusion, patient outcome is tied to nurse education level. Reference Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. Cho, E., Sloane, D. M., Kim, E. Y., Kim, S., Choi, M., Yoo, I. Y. … & Aiken, L. H. (2015). Effects of nurse staffing, work environments, and education on patient mortality: an observational study. International journal of nursing studies, 52(2), 535-542. REPLY2 Nursing practice, nursing as profession, nurses’ role and responsibilities have changed and evolved since the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM) report and Affordable Care Act (ACA). Nurses has become the essential workforce to change and improve the American health care system. Their direct and continuous interaction with patients and families, make them crucial resources of information regarding patient health condition and health care needs. Likewise, they are the advocates for patient rights, and quality, equal, and safe care. However, nurses must get better education to provide the community with safer, higher and adequate care, and play the important role to influence laws and legislations that affect patient health care delivery services. To meet the country’s health care demands, at least 80% of the existing nursing workforce should be prepared at the baccalaureate degree level by 2020. Concomitantly, baccalaureate-level nursing degrees should become the entry point of general nursing practice. Higher level of nursing education has showed better quality of care, less patient care errors, less mortality and better patient outcomes. This is evident in the research findings pertaining to nursing education and the rates of patient morbidity and patient mortality, which are significantly less among baccalaureate-prepared nurses (Kutney-Lee, Sloane, & Aiken, 2013). I work as clinical supervisor in a local hospital in Los Angeles. I have the opportunity to work with new grads who received orientation and training in the Versant program. This program provides new grads with BSN the opportunity to get experience and apply their nursing skills in acute care settings. Even thought, those nurses do not have experience in patient care, they are very knowledgeable about patient safety, assessments, nursing care, etc. They are excellent critical thinkers about patient health conditions changes, they know how to communicate with other health care professionals, they are flexible regarding patient assignments, influence health care decisions, and advocate for patient and family rights.  Reference: Grand Canyon University, 2018.Chapter 3 in Trends in Health Care: A Nursing Perspective. https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/trends-in-health-care_a-nursing-perspective_1e.php Kutney-Lee, A., Sloane, D. M., & Aiken, L. H. (2013). An increase in the number of nurses with baccalaureate degrees is linked to lower rates of postsurgery mortality. Health Affairs (Project Hope), 32(3), 579–586. doi: 10.1377/hlthaff.2012.0504

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