course materials

1. NURS 412 Incivility in Nursing Practice in a Hospital
NURS 412 Incivility in Nursing Practice in a HospitalNURS 412 Incivility in Nursing Practice
in a HospitalScholarly Paper: Using the PICOT process, analyze a current nursing practice-
related issues.Select an issue from your NURS 412 clinical practice and write a PICOT
research question.The scholarly paper should be typed, double spaced, 12 point, Times New
Roman using APA format, and limited to 6 pages including title and reference pages. The
references cannot be older than 2018.EVALUATION OF UNDERGRADUATE SCHOLARLY
PAPER RUBRIC WILL BE USED. your position with references no older than 2018 from at
least two peer reviewed journal reference articles.Also use the attached rubric to ensure
proper completion of the assignmenti have also attached samples as a guide do not
plagiarize the sample.let me know the topic you are choosing to write about. and let me
know if you have any questions.ORDER NOW FOR CUSTOMIZED, PLAGIARISM-FREE
PAPERS1 Evidence Based Practice PICOT ? Dr. Birthale Archie ? 1Transition into
Professional Nursing Practice ? NURS 425 / Week 7 2 Definition Evidence Based Practice
(EBP) ? According to Melynk et. Al. (2010) ? “a problem-solving approach to the delivery of
health care that integrates the best evidence from studies and patient care data with
clinician expertise and patient preference and values.” (p. 1) 3 What is PICOT Statement ?
Carefully formulated question that encompass the acronym PICOT and the ? “T” when
pertinent. 1. Identify the problem or population(P) intervention (I) 3. Comparison (C) 4.
Outcome(s) (O) 5. Timeframe (T) Template for PICOT QUESTION 4 ?
https://www.aaacn.org/sites/default/files/documents/miscdocs/1e_PICOT_Questions_tem
plate.pdf ? Handout in class. ? Adapted from the PICOT Questions Template; Ellen Fineout-
Overholt, 2006. This form may be used for educational & research purposes without
permission 5 Definitions for Terms ? Intervention/Therapy: Questions addressing the
treatment of an illness or disability. ? Etiology: Questions addressing the causes or origins of
disease (i.e., factors that produce or predispose toward a certain disease or disorder). 6
Definitions for Terms Cont’ ? Diagnosis: Questions addressing the act or process of
identifying or determining the nature and cause of a disease or injury through evaluation. 7
Definitions for Terms Cont’ ?NURS 412 Incivility in Nursing Practice in a
HospitalPrognosis/Prediction: Questions addressing the prediction of the course of a
disease. 8 Definitions for Terms Cont’ ?Meaning: Questions addressing how one experiences
a phenomenon. 9 Intervention ? Intervention: In African-American female adolescents with
hepatitis B (P), how does acetaminophen (I) compared to ibuprofen (C) affect liver function
(O) timeframe (T)? 10 Therapy ? Therapy: In children with spastic cerebral palsy (P), what

2. is the effect of splinting and casting(I) compared to constraintinduced therapy (C) on two-
handed skill development (O)? 11 Prognosis / Prediction ? Prognosis/Prediction: 1) For
patients 65 years and older (P), how does the use of an influenza vaccine (I) compared to
not received the vaccine (C) influence the risk of developing pneumonia (O) during flu
season (T)? 2) In patients who have experienced an acute myocardial infarction (P), how
does being a smoker (I) compared to a non-smoker (C) influence death and infarction rates
(O) during the first 5 years after the myocardial infarction (T)? 12 Diagnosis ? Diagnosis: In
middle-aged males with suspected myocardial infarction (P), are serial 12-lead ECGs (I)
compared to one initial 12-lead ECG (C) more accurate in diagnosing an acute myocardial
infarction (O)? 13 Etiology ? Etiology: Are 30- to 50-year-old women (P) who have high
blood pressure (I) compared with those without high blood pressure (C) at increased risk
for an acute myocardial infarction (O) during the first year after hysterectomy (T)? 14
Meaning ? Meaning: How do young males (P) with a diagnosis of below the waist paralysis
(I) perceive their interactions with their romantic significant others (O) during the first year
after their diagnosis (T)? 15 References ? Birthale Archie, DNP, MSN, BS, RN ? Fineout-
Overholt, E. Template for Asking PICOT Questions. Retrieved October 7, 2019, from
http://www.unm.edu/~unmvclib/cascade/handouts/PICOTtemplates.pdf ? Library
Guides: Evidence Based Nursing Practice: Pico(t) and Clinical Questions
https://journals.lww.com/nursing/fulltext/2014/02000/To_ma
ke_your_case,_start_with_a_PICOT_question.7.aspx#pdf-link
https://libraryguides.missouri.edu/c.php?g=28271&p=174073 ?
https://libraryguides.nau.edu/c.php?g=665927&p=4682772 ?
https://journals.lww.com/nursing/fulltext/2014/02000/To_make_your_case,_sta
rt_with_a_PICOT_question.7.aspx#pdf-link Running head: ACCOUNTABILITY EDUCATION: A
LEGISLATIVE ISSUE Accountability for Continued Education: A Legislative Issue
Introduction The United States has made efforts to develop its health care industry with a
focus on quality, affordability, and access to healthcare services. The increasing demand for
health care services over the past decade(s) and the demand for quality medical care have
stimulated the 1 ACCOUNTABILITY FOR EDUCATION: A LEGISLATIVE ISSUE 2 growth of
the nursing population.NURS 412 Incivility in Nursing Practice in a HospitalIssued in a 2010
report by the Institute of Medicine (IOM), called The Future of Nursing: Leading Change,
Advancing Health, highlighted the complexities of care have been evolving; therefore,
nursing education must also advance to meet the needs of future healthcare requirements.
The recommendation sought to increase the number of nurses to obtain their bachelor’s
degree to 80% by the year 2020. With more than 3 million members and counting, the
number of nurses embody the largest sector of healthcare industry according to the IOM
(2010). At the time of this report’s release, approximately 50% of nurses achieved their
bachelor’s degree or had their bachelor’s degree. Currently, in 2019, a 10% increase in
nurses with a BSN evolved making the total percentage to 60%. Consequently, the goal has
not been met; however, the initiative has made some strides (Schneider, 2016). Such
demand requires the federal government, state department, and other policy-related bodies
to make decisions geared toward closing the nursing educational gap. The demand has also
triggered professional training of nurses in various certified nursing institutions and

3. organizations. Through research, the federal government of the U.S, American Nurses
Credentialing Center (ANCC) and other legal bodies ed an increase in nurses requiring a
four plus year education to obtain a bachelorette’s degree. A push for new legislation
requires participation by state governances along with enough documented proof to
convince states to adopt this new policy. This paper aims to address the PICOT formulated
question: In nursing practice, how does clinical competence of BSNs compared to that of
RNs with an associate degree influence the rate of mortality among patients over
time?NURS 412 Incivility in Nursing Practice in a HospitalProblem ACCOUNTABILITY FOR
EDUCATION: A LEGISLATIVE ISSUE 3 The pivotal work of Aiken, Clarke, Cheung, Sloane,
and Silber gathered a critical finding of evidenced based research conducted by Olga
Yakusheva, researcher at the University of Michigan. The study concluded solidly that for
every 10% increase in the amount of BSN nurses working in a hospital, patient mortality
would decrease by approximately 10% as well. Another statistic worth mentioning is a
decrease of approximately 5% in a failure to rescue case. A condensed report using these
research studies provided by the Institute of Medicine offers compelling evidence to a
larger quantity of nurses entering the workforce to pursue a Bachelorette’s degree. Thus,
legislators have been prompted even more now to make legal discussions over the level of
education required for the RN to fully practice their scope. According to Zittel et al. (2016),
the barrier to the full practice by RN nurses to the BSN’s level is the lack of education in the
following competencies: “leadership, systems reasoning, quality improvement, community
care, health policy, and health policy finances” (Zittel, 2016). The aforementioned skills are
essential to meet the exponentially increasing complexities of today’s diverse population.
Intervention The Scope and Standards of Practice of an RN according to ANA (2015),
emphasizes the RN’s responsibility to continue their education and competency of nursing
practice, this includes an ongoing pursuit of credentials and simply, a lifetime of learning.
With consideration to the standard of education and educational profession, an issue found
by Panel members is the rather confusing non-standardized educational requirements of an
RN. A group of legislators asked a rather compelling question, what type of examination is
given to a BSN vs. an RN to determine the difference in credentialing? A strong advocate
explained that the same examination for licensure was given to associate level nurses and
bachelor level nursing. The legislators were ACCOUNTABILITY FOR EDUCATION: A
LEGISLATIVE ISSUE 4 baffled by this profound indifference (Zittel et al., 2016) because the
lack of clear differentiation in the practice of an ADNs vs. a BSN is unclear to the public.
NURS 412 Incivility in Nursing Practice in a HospitalThe strongest advocates that the
legislation for all nurses to require a bachelorette’s degree were educators themselves–
Faculty and deans from associate degree programs (Zittel et al., 2016). Though, Unions of
different sorts opposed the idea, stating that “a baccalaureate of science (BS) in Nursing is
not essential; that is, the bachelor’s degree could be obtained in any major” (Zittel et al.,
2016). These Unions also claim that any new legislation include funding to RN’s with an
associate degree who are required to continue their education to earn a Bachelor’s (Zittel et
al., 2016). Subsequently, Healthcare advocate, medical associations and other healthcare
professional bodies, and the federal government have the task of discussing limiting factors
to earning a BSN; cost and time. Tuition for BSN trainees is high, and the difference in

4. payment between a BSN and an ADN is low or equivalent (Matthias, 2015). Nonetheless,
AACN now requires hospitals hoping to earn Magnet status to provide proof of plans to
meet the 80% recommendation (2014) and some facilities like the VA (Veterans
Administration) enacted a policy to increase the entry level pay for BSN nurses as an
incentive (Schnieder, 2016). Furthermore, states with combined interests known as
compact states allow BSN nurses to qualify to practice in those states without additional
licensing requirements (The College for the People, 2017). These nurses can simply move to
another state with a transferable, ‘universal’ license. Comparison The nursing practice or a
BSN and an ADN both practice within the same scope. There is no clinical difference and
licensure; but the education requirements/credentials for the BSN are ACCOUNTABILITY
FOR EDUCATION: A LEGISLATIVE ISSUE 5 practically doubled in comparison. A nurse with
a BSN performs in more complex procedures, utilizing critical thinking skills while under
the doctor’s supervision; along with obtaining a leadership position as a charge nurse in
most facilities (The College for the People, 2017). Olga Yakusheva, researcher at the
University of Michigan, mentioned above found an alarming correlation between patient
mortality and educational preparedness. A decrease of 5% failure to rescue scenarios and a
10% reduction of deaths. NURS 412 Incivility in Nursing Practice in a HospitalThis is a
significant percentage, last updated four years ago so one could assume the percentage has
increased. Outcome/Time After a 14-year struggle, lobbyists succeeded. New York State
finally passed their “BSN in 10” law. This means that a Baccalaureate Degree in nursing is a
mandatory requirement within a 10-year window after receiving their initial license
(Maracrac, 2017). Though, New York is just one state out of 50. Noteworthy, it took
approximately 120 organizations to write letters in of this new legislation including the
“medical society, the healthcare association representing acute and long-term care facilities,
and from the councils for both the associate degree and baccalaureate degree and higher
programs” (Maracrac, 2017). Strong advocates contested that the only way to ensure that
every RN will earn a BSN is to make it a mandatory requirement. This can only be
accomplished in some jurisdictions though passing a bill by the state (Zittel et al., 2016). A
new prediction forecasts that by the year 2025, the 80% benchmark will be reached.
Conclusion This paper aimed to address the PICOT formulated question: In nursing practice,
how does clinical competence of BSNs compared to that of RNs with an associate degree
influence ACCOUNTABILITY FOR EDUCATION: A LEGISLATIVE ISSUE 6 the rate of mortality
among patients over time? The study concluded solidly that for every 10% increase in the
amount of BSN nurses working in a hospital, patient mortality would decrease by
approximately 10% as well. Another statistic worth mentioning is a decrease of
approximately 5% in a failure to rescue case. After a 14-year struggle, lobbyists succeeded.
New York State finally passed their “BSN in 10” law. This means that a Baccalaureate Degree
in nursing is a mandatory requirement within a 10-year window after receiving their initial
license (Maracrac, 2017). Though, New York is just one state out of 50. Perhaps, more states
will follow the trend and mandate this requirement, especially when people’s lives are at
stake. References Aiken, L. H., Clarke, S., Cheung, R., Sloane, D., & Silber, J. (2003).
Educational levels of hospital nurses and surgical patient mortality. Journal of the American
Medical Association, 290(12), 1617-1623. ACCOUNTABILITY FOR EDUCATION: A

5. LEGISLATIVE ISSUE 7 American Association of Colleges of Nursing (AACN), (2014). Fact
sheet: The Impact of Education on Nursing Practice. Retrieved from
http://www.aacn.nche.edu/mediarelations/fact-sheets/impact-of-education American
Nurses Association. (2015). Nursing: Scope and standards of practice (3rd ed.). Washington,
DC: Author. NURS 412 Incivility in Nursing Practice in a Hospital