WASHINGTON,
D.C., September 23, 2003 - The American Association of
Colleges of Nursing (AACN) applauds a landmark new study
released today which finds that surgical patients have
a "substantial survival advantage" if treated
in hospitals with higher proportions of nurses educated
at the baccalaureate or higher degree level. In the study,
Dr. Linda Aiken and her colleagues at the University of
Pennsylvania's Center for Health Outcomes and Policy Research
found that patients experienced significantly lower mortality
and failure to rescue rates in hospitals where more highly
educated nurses are providing direct patient care.
"Dr.
Aiken's research clearly shows that baccalaureate nursing
education has a direct impact on patient outcomes and
saving lives," said Dr. Kathleen Ann Long, president
of AACN. "Nurses with baccalaureate and higher degrees
are particularly well-suited to meeting the demands of
today's complex health system, reducing patient risk,
and lowering mortality rates."
The
study, titled "Educational Levels of Hospital Nurses
and Surgical Patient Mortality," is published in
this week's issue of the Journal of the American Medical
Association. Key findings include:
- In
hospitals, a 10 percent increase in the proportion of
nurses holding Bachelor of Science in Nursing degrees
(BSN) decreased the risk of patient death and failure
to rescue by 5 percent.
- Patient
mortality and failure to rescue would be 19 percent
lower in hospitals where 60 percent of nurses had BSNs
or higher degrees than in hospitals where only 20 percent
of nurses were educated at that level.
- If
the proportion of BSN nurses in all hospitals was 60
percent rather than 20 percent, 17.8 fewer deaths per
1,000 surgical patients would be expected.
- At
least 1,700 preventable deaths could have been realized
in Pennsylvania hospitals alone if BSN prepared nurses
had comprised 60 percent of the nursing staff and the
nurse to patient ratios had been set at 1 to 4.
- Nurses'
years of experience had no impact mortality or failure
to rescue rates.
The
study was based on an analysis of the outcomes of 232,342
surgical patients in 168 Pennsylvania hospitals over a
20-month period. The percentage of baccalaureate and higher
degree nurses in those hospitals ranged from 0 to 77 percent.
Only 11 percent of the hospitals studied had 50 percent
or more of their registered nurses prepared at the baccalaureate
or higher degree level.
AACN
has long advocated for creating a more highly educated
nursing workforce in the interest of improving patient
safety and providing better care. Currently, only 43 percent
of the registered nursing workforce possesses baccalaureate,
master's or doctoral degrees. Compounding the problem
is the fact that very few nurses prepared in associate
degree programs continue their education once they enter
the workforce. According to the latest national sample
survey of registered nurses conducted by the U.S. Department
of Health and Human Services, only 16 percent of associate
degree prepared nurses obtain post-RN nursing or nursing
related degrees.
"Nurses
sign a social contract with patients to provide the best
care possible and fulfilling that contract means acquiring
the knowledge and expertise needed to get the job done
right," said Dr. Geraldine Bednash, AACN's Executive
Director. "As the new study shows, experience is
no substitute for rigorous baccalaureate and higher degree
education. AACN will continue to encourage registered
nurses prepared at pre-baccalaureate levels to advance
their education and will work with employers and fellow
nurse educators to create a more highly educated nursing
workforce."
The
University of Pennsylvania study further recommends that
public financing of nursing education should aim at shaping
a workforce best prepared to meet the needs of the population.
"The federal Division of Nursing and other policy
advisors to Congress have long advocated for increasing
the number of baccalaureate prepared nurses in the workforce,"
said Dr. Long. "The Aiken study upholds the recommendations
made by these government authorities and serves as a call
to focus federal strategies to address the nursing shortage
on facilitating access to baccalaureate and higher degree
programs in nursing."
AACN
advises consumers concerned about their safety to check
with hospitals and other health care facilities to determine
the proportion of baccalaureate and higher degree prepared
nurses on staff before scheduling surgery or other serious
procedures.
Today,
AACN released a new fact sheet on "The Impact of
Education on Nursing Practice" to further inform
the health care community and the public about the value
of baccalaureate prepared nurses. This fact sheet discusses
the three approaches to entry-level nursing education,
the benefits of baccalaureate education, the need to differentiate
practice, and the growing support for a more highly educated
nurses. Nurse executives, federal agencies, the military,
leading nursing organizations, health care foundations,
Magnet Hospitals, and minority nurse advocacy groups all
recognize the unique value that baccalaureate-prepared
nurses bring to the practice setting. The fact sheet may
be accessed online at http://www.aacn.nche.edu/edimpact.
