Academic journal article Nursing Praxis in New Zealand

The Impact of Postgraduate Education on Registered Nurses Working in Acute Care

Academic journal article Nursing Praxis in New Zealand

The Impact of Postgraduate Education on Registered Nurses Working in Acute Care

Article excerpt


Postgraduate education is important to advance nursing practice at both individual and professional levels (Aitken, Currey, Marshall, & Elliott, 2008; Cragg & Andrusyszyn, 2004). Since 2007, Health Workforce New Zealand (HWNZ) (formally the Clinical Training Agency, a subunit of the New Zealand Ministry of Health) has provided District Health Boards (DHBs) with significant funding to support nurses to undertake postgraduate education (Clinical Training Agency, 2009). In one large DHB during every academic semester since 2007 over 200 nurses (including primary health care nurses) have undertaken postgraduate education. Additionally, the DHB's Nurse Entry to Practice Programme includes one postgraduate paper (McDonald, Willis, Fourie, & Hedgecock, 2009). By the end of the first semester in 2009, 249 nurses had completed a postgraduate qualification. Many of these nurses work in acute general medical and surgical wards. Senior nurses, however, have reported mixed opinions as to whether the increase in registered nurses with postgraduate qualifications in these acute settings has improved patient outcomes. In this article we report the results of a survey that sought perceptions of registered nurses, nurse managers and nurse educators, about whether the postgraduate education of nurses positively impacted on patient clinical outcomes.

Prior to HWNZ funding the uptake of postgraduate education was slow. In 1999 only 0.7% nurses renewing their practising certificates indicated they had a postgraduate qualification. By 2000 this had increased to 12.7% (Nursing Council of New Zealand, 2000). Support from HWNZ funding has seen the percentage of registered nurses with postgraduate qualifications continuing to increase to 20.7% as at March 2010 (personal communication with N. Hay, Nursing Council of New Zealand on 30 March 2010). Clearly there is need for evidence that demonstrates New Zealand's investment in the postgraduate education of registered nurses is beneficial for patients.

Literature Review

Advocates of postgraduate education claim that it advances nursing practice and enables personal and professional development (Armstrong & Adam, 2002; Cooley, 2008; Cragg & Andrusyszyn, 2004; Pelletier et al., 2003; Spence, 2004a, 2004b; White, 2009).

Internationally, masterate level education is promoted as the appropriate preparation for specialty areas and advanced nursing practice roles (Aiken et al., 2003; Currie & Watterson, 2009; Pelletier et al., 2003; Wilson-Barnett, 2006).

Research has shown a range of benefits from postgraduate education, for instance nurses' abilities to think critically and apply research to practice were found to be enhanced following completion of postgraduate study (Armstrong & Adam, 2002; Cragg & Andrusyszyn, 2004; Hardwick & Jordan, 2002; Pelletier, Donoghue, & Duffield, 2003; Spence, 2004a, 2004b; Whyte, Lugton, & Fawcett, 2000). Such study promotes broader and more holistic thinking, so that nurses are better able to see the 'bigger picture' of their nursing practice. The knowledge and skills following completion of a postgraduate level client assessment paper contribute to increased confidence (Cotterill-Walker, 2012), and to better assessment of patients. (Hardwick & Jordan, 2002; Pelletier et al., 2003; Spence, 2004a). Nurses who have completed a postgraduate qualification make more informed decisions and are more likely to support practice with evidence, and to advocate for patients by questioning doctors' decisions and debating treatment options (Pelletier et al., 2003). Other benefits include improved communication skills with patients, families and colleagues (Pelletier et al., 2003; Rassool & Oyefeso, 2007; Spence, 2004a, 2004b), and enhanced collaboration and communication with other health professionals (Caldwell, 2001; Cooley, 2008; Cragg & Andrusyszyn, 2004; Spence, 2004a). These in turn have been found to be associated with lower patient mortality rates (Schmalenberg & Kramer, 2009). …

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