Factors related to progression and graduation rates for RN-to-bachelor of science in nursing programs: searching for realistic benchmarks.

Measurement and analysis of progression and graduation rates is a well-established activity in schools of nursing. Such rates are indices of program effectiveness and student success. The Commission on Collegiate Nursing Education (2008), in its recently revised Standards for Accreditation of Baccalaureate and Graduate Degree Nursing Programs, specifically dictated that graduation rates (including discussion of entry points, timeframes) be calculated for each degree program. This context affects what is considered timely progression to graduation. If progression and graduation rates are critical outcomes, then schools must fully understand their measurement as well as interpretation of results. Because no national benchmarks for nursing student progression/graduation rates exist, schools try to set expectations that are realistic yet academically sound. RN-to-bachelor of science in nursing (BSN) students are a unique cohort of baccalaureate learners who need to be understood within their own learning context. The purposes of this study were to explore issues and processes of measuring progression and graduation rates in an RN-to-BSN population and to identify factors that facilitate/hinder their successful progression to work toward establishing benchmarks for success. Using data collected from 14 California schools of nursing with RN-to-BSN programs, RN-to-BSN students were identified as generally older, married, and going to school part-time while working and juggling family responsibilities. The study found much program variation in definition of terms and measures used to report progression and graduation rates. A literature review supported the use of terms such as attrition, retention, persistence, graduation, completion, and success rates, in an overlapping and sometimes synonymous fashion. Conceptual clarity and standardization of measurements are needed to allow comparisons and setting of realistic benchmarks. One of the most important factors identified in this study is the potentially prolonged RN-to-BSN timeline to graduation. This underlines the need to look beyond standardized educational norms for graduation rates and consider the realities of "persistence" by which these students are successful in completing their studies. It also raises the question of whether student success and program success/effectiveness are two separate measures or two separate events on one progression timeline. While clarifying our thinking about success in this population of students, the study raised many questions that warrant further research and debate.

The impact of nursing practice on the history and effectiveness of total parenteral nutrition.

Nutrition support nursing grew out of the development of total parenteral nutrition in the late 1960s. Nurses contributed to the development of safe and effective delivery of parenteral nutrition and continue to serve on nutrition and metabolic teams in a variety of ways. Research demonstrating the positive effect of the nurse and the team are presented here, along with the history, evolution, and current state of nutrition support nursing.

The peripherally inserted central catheter: what are the current indications for its use?

The use of peripherally inserted central catheters (PICCs) has dramatically increased since first being used for IV therapy in the 1980s. Currently, sales of PICCs are second only to acute care central venous catheters and exceed all other types of long-term venous access devices. The use of PICCs has also increased dramatically in the home care setting. A number of studies have examined the incidence of PICC complications in comparison to other central venous access devices. Although complications differ, most reports have concluded that the type and rate of PICC complications compare favorably with other access devices in the short-term; however, dwell times beyond a few weeks have been associated with decreased complication-free days and lower device survivability rates. The PICC seems to be most appropriate for acute care or short-term home care use and may not be the ideal central venous access device when the need for long-term access is anticipated.