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Top-of-License Nursing Practice, Part 2: Differentiating BSN and ADN Perceptions of Top-of-License Activities
Jacqueline Loversidge1, Po-Yin Yen, Esther Chipps
1Author Affiliations: Assistant Professor of Clinical Nursing (Dr Loversidge); Adjunct Assistant Professor (Dr Yen); Associate Professor of Clinical Nursing (Dr Chipps); Director (Dr Gallagher-Ford), Center for Transdisciplinary Evidence-based Practice and Helene Fuld Health Trust National Institute for EBP in Nursing & Healthcare; and Clinical Associate Professor (Dr Gallagher-Ford), College of Nursing, Ohio State University; Director (Dr Yen), BMI Summer Internship Program, and Assistant Professor-Clinical, Department of Biomedical Informatics, College of Medicine, Ohio State University; and Clinical Nurse Scientist (Dr Yen); Clinical Nurse Scientist (Dr Chipps); Associate Director (Ms Genter), Nursing CE Programming & Education, Health System Nursing Services; and Administrator (Dr Buck), Health System Nursing Quality, Research, Education, and EBP, Wexner Medical Center, Ohio State University, Columbus.
Objective:
The aim of this study was to describe differences in associate degree (ADN) and baccalaureate degree-prepared (BSN) nurses' perceptions of top-of-license (TOL) practice.
Background:
To date, no empirical work has examined whether ADN and BSN nurses approach TOL practice nursing activities differently.
Methods:
We conducted a qualitative pilot study with focus groups to explore the perceptions of a group of ADN- and BSN-prepared nurses concerning nursing activities and their relation to TOL practice.
Results:
Subthemes emerged differentiating how ADN and BSN nurses perceived their responsibilities related to critical thinking, communication, and patient education. For professional nursing care, 5 subthemes further emerged: (a) approaches to assessment, (b) chart review, (c) psychosocial patient care, (d) documentation, and (e) handoff.
Conclusions:
The differences identified in approaches to TOL practice activities by educational preparation have implications for staffing patterns that can optimize the contribution of ADN- and BSN-prepared nurses. Further research is indicated.
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