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Preparing Nurses for Community Health Care: A Comparative Study of the ADN and BSN Programs

Masoud Ghaffari
2018 International Journal of Medical and Health Sciences Research  
Article History Keywords Nursing education Community health ADN curriculum BSN curriculum Home health nursing Entry level nursing. Because of current changes in our society and the healthcare system, it is important to be aware of the expertise and efficiency of nurses in terms of how they are prepared to meet the health care needs of our society today and in the future. Along with this awareness, it is important for us to examine carefully the manner in which nurses are educated to meet the
more » ... ated to meet the increasing demands of a changing society and the increased need for community health care. The purpose of this study was to compare the degree to which ADN's and BSN's graduates, from selected schools in the Northeast region of the United States that were exposed to community health nursing concepts during their educational programs. This descriptive, non-experimental study compared the community health orientation of graduating nursing and the degree of student exposure to community health concepts in their curricula. Data analysis revealed a difference in the perceived exposure to community health nursing concepts, with BSN students perceiving greater exposure to the concepts. Also, there was a difference in the community health orientation of students, with the highest orientation demonstrated in BSN programs. Contribution/Originality: This paper contributes to the existing literature regarding the importance of incorporating community health contents into Associate Degree Nursing curricula in order to prepare new ADN graduates to work in the home health care field and community health settings. today and in the future. Along with this awareness, it is important for us to examine carefully the manner in which nurses are educated to meet the increasing demands of a changing society and the increased need for community health care. By examining the trends affecting community health care delivery and the community health nursing content of nursing programs, we can make a better judgment as to whether nurses are educated appropriately for health care services now and in the future. The schools educating students to become registered nurses offer associate degree (ADN, two year) and baccalaureate (BSN, four year) nursing programs. Still, there are a few schools offering diploma (three year) program. Although there are a variety of nursing programs available, studies suggest that baccalaureate nurses are the only group of graduates prepared in undergraduate to work in community health [1, 2] . However, a few ADN programs also include community health nursing concepts as part of their instruction [3] . Consequently, it is not always clear what types of exposure to community health concepts nurses receive by identifying the sort of program from which they graduated. In the 1988 National Sample Survey of Registered Nurses [4] 37% of the community health nurses reported a baccalaureate degree as their highest educational preparation. Also, this survey indicated that the percentage of nurses employed in community health settings increased 26%. These statistics and trends reflect a phenomenon of concern to community health nursing-the need for education in community health nursing. National League for Nursing [5] reported percentage of graduations by program type as: ADN 32% and BSN 27%. The mission of undergraduate nursing education programs is to prepare nurses for practice environments they will encounter when they enter the profession. Curricula are then designed and implemented to meet those anticipated demands. Nevertheless, professional nurses need to be prepared to deliver care across settings, not just in the community or in hospitals. It is the content of the curriculum, rather than specific practice settings, that should be central [6] . et al. [7] asserted that ADN curricula emphasize competencies focused on direct bedside nursing, care coordination, and management. The American Nurses Association [8] defined competency as an expected level of performance that integrates knowledge, skills, and behaviors. Competence implies a performance aspect of a job or position, whereas competency implies a non-task-oriented behavior supporting this performance. ADN students do not gain experience in community settings initially. Students build competence in communitycare in their AND to BSN curriculum, when expand their conception of nursing practice from direct patient care to nursing within a system of care. Community health is the provision of nursing care that is directed at improving the health of the entire community. Community health nursing focuses on prevention of disease. It is concerned with clients across their life span but puts special emphasis on high risk populations. Community health nursing may take place in a home, a clinic, or any place an individual or a population can be served. PURPOSE OF THE STUDY The purpose of this study was to compare the degree to which ADN's and BSN's graduates, from selected schools, were exposed to community health nursing concepts during their educational programs. Differences in students' preparation for community health nursing were investigated to answer the following research question, "What are the differences in degree of exposure to community health concepts and community health orientation between nursing students from ADN and BSN programs?" HYPOTHESIS Statically significant differences in the degree of exposure to community health nursing concepts and community health orientation will be observed between students in ADN and BSN programs.
doi:10.18488/journal.9.2018.52.32.45 fatcat:452c7nyhfjaqbeskq4d4jjh5py