Virginia Commonwealth University, School of Nursing, Department of Adult Health & Nursing Systems, Richmond, VA.
University of Texas at Austin, School of Nursing, Division of Adult Health, Austin, TX.
Nurs Outlook. 2019 Jul-Aug;67(4):381-392. doi: 10.1016/j.outlook.2019.02.008. Epub 2019 Feb 16.
Changing health care needs are driving new models of care that emphasize care coordination, health promotion, and disease management by registered nurses (RNs). A skill-mix favoring professional (baccalaureate or above) over technical (less than baccalaureate) education is promoted by national initiatives.
To examine the academic preparation and progression of general practice RNs in practice settings across the care continuum.
Secondary analyses of data from the Texas Board of Nurses RN Licensure databases in 2008 and 2014.
Overall the professional skill-mix for general practice RNs improved from 47.1% to 50.2%. Disparities were identified in home health (31.6%), long-term care (27.8%) and nonmetropolitan areas (31.7%). Role change was the strongest correlate of academic progression.
Non-hospital and rural practice settings may be vulnerable to the effects of an undereducated RN workforce. More effective reimbursement policies and employer incentives are needed to drive academic progression and address disparities across practice settings.
不断变化的医疗保健需求正在推动新的护理模式，这些模式强调由注册护士（RN）进行护理协调、促进健康和疾病管理。国家倡议提倡有利于专业（学士或以上）而非技术（低于学士）教育的技能组合。
在整个护理连续体的实践环境中，检查普通科执业护士的学术准备和发展情况。
对 2008 年和 2014 年德克萨斯州护士委员会 RN 执照数据库的数据进行二次分析。
总体而言，普通科执业护士的专业技能组合从 47.1%提高到 50.2%。在家庭保健（31.6%）、长期护理（27.8%）和非城市地区（31.7%）存在差异。角色转变是学术进步的最强相关因素。
非医院和农村实践环境可能容易受到教育程度较低的 RN 劳动力的影响。需要更有效的报销政策和雇主激励措施，以推动学术进步，并解决不同实践环境中的差异。
