This article describes an innovative learning program, designed for associate degree nurse (ADN) graduates, developed at the visiting Nurse Service of New York (VNSNY) to expand its hiring pool of potential applicants to home health care nursing positions. The program, "Transitions to Home Health Care," provides a strong emphasis on independent judgment, assessment skills, and collaboration with other professions and resources outside the home health care agency. In view of the expanding number of ADN graduates and the increasing competition for a limited number of new bachelor of science in nursing (BSN), VNSNY developed and is testing a model that combines a specially designed one-year didactic educational course and a clinical practice internship program to prepare new ADN graduates to work in the home health care field at a level more comparable to that of BSN graduates. To date, VNSNY has had preliminary success with this new approach.
Greater accountability for patient outcomes, reduced reimbursement, and a protracted nursing shortage have made employee and patient satisfaction results central performance metrics and strategic imperatives in healthcare. Key questions are whether the two interact and if so, how can that relationship be leveraged to obtain maximum gains in both employee and patient satisfaction. This article examines the experience of a large, nonprofit home care agency in exploring these issues. The agency found that organizational commitment to patient care and customer service are fundamental to patient satisfaction. The more employees perceived that the organization is focused on quality and customers, the more patient satisfaction increased. Among nurses, work-life balance, fair compensation, and regard for employees all influenced patient satisfaction.
In view of shortages of baccalaureate-trained nurses, the Visiting Nurse Service of New York embarked on an initiative to determine whether associate degree nursing graduates, through an intensive internship program, can perform on par with baccalaureate nursing (BSN) graduates. The associate degree in nursing (ADN) internship resembles the existing internship for BSN graduates but includes supplemental educational components. A quasi-experimental evaluation design was developed to examine the formative and summative outcomes of the initiative. ADN interns were compared with BSN interns on retention in the internship, clinical thinking, assessment skills, productivity, and intention to remain in nursing. Data were collected at pre-and postintervention intervals. Findings reveal few significant differences between the ADN and BSN interns, suggesting that with competitive recruitment, appropriate support, and supplementary training, ADN interns can perform on par with their BSN counterparts. The small number of participants in the internship programs presents a significant limitation to the study findings.
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