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AACN Applauds the New Carnegie Foundation Report Calling for a More Highly Educated Nursing Workforce

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Press Release  
For Immediate Release

AACN Applauds the New Carnegie Foundation Report Calling
for a More Highly Educated Nursing Workforce

Evidence Clearly Links Patient Safety and Lower Mortality Rates to
Nurses Prepared at the Baccalaureate and Graduate Levels

WASHINGTON, D.C., January 8, 2010 – The American Association of Colleges of Nursing (AACN) applauds Dr. Patricia Benner and her team at the Carnegie Foundation for the Advancement of Teaching for recognizing the critical role education plays in a nurse’s ability to practice safely and achieve optimal outcomes in their new book titled Educating Nurses: A Call for Radical Transformation. Consistent with AACN’s calls to enhance the education of professional nurses, the landmark study recommends preparing all entry-level registered nurses (RNs) at the baccalaureate level and requiring all RNs to earn a master’s degree within 10 years of initial licensure.

“Moving to create a more highly educated nursing workforce is in the best interest of the patients we serve,” said AACN President Fay Raines. “The new Carnegie report provides a clear blueprint for the important work that must occur to transform how nurses are prepared for contemporary practice and leadership roles. AACN stands ready to help move this agenda forward by working collaboratively with all stakeholders interested in striving for excellence and advancing the nursing profession in order to improve health care.”

The Carnegie report on nursing underscores that “profound changes in nursing practice call for equally profound changes in the education of nurses and the preparation of nurse educators.” The authors found that many of today’s new nurses are “undereducated” to meet practice demands across settings. Their strong support for high quality baccalaureate degree programs as the appropriate pathway for RNs entering the profession is consistent with the views of many leading nursing organizations, including the American Nurses Association, the American Organization of Nurse Executives, and AACN. As the voice for baccalaureate and graduate nursing education, AACN was one of a handful of nursing organizations that provided survey assistance as well as consultation with the report’s authors.

In the report, Dr. Benner and her colleagues call for dramatic changes in how nurses are educated, including a stronger integration of clinical and classroom instruction as well as more rigorous scholarship demands on nursing students in several content areas, including nursing science and technology. Other recommendations and key observations include:

  • Developing a set of prerequisites for all students entering nursing education programs.
  • Recruiting more diverse faculty and students into nursing programs.
  • Strengthening articulation agreements between associate degree (ADN) and higher degree nursing programs and creating more ADN-to-master’s degree programs.
  • Immersing nursing students in the discipline during the first two years of study.
  • Increasing the variety of clinical settings in which nursing students are educated.
  • Requiring a one-year clinical residency for all new nursing graduates.
  • Enhancing student competency in the areas of inquiry and research.
  • Preparing nurses to be influential leaders and innovators in the political and public arenas.

Given AACN’s focus on faculty development and addressing the shortage of nurse educators, we were pleased to see a number of recommendations focused in this area including:

  • Integrating teacher education courses in all master’s and doctoral nursing programs.
  • Ensuring that advanced clinical practice preparation is embedded in master’s programs with a nursing education major.
  • Addressing the faculty shortage by raising salaries to keep them in line with clinical salaries and teaching positions in other disciplines.
  • Providing faculty with significant resources to stay clinically current.
  • Convening all interested parties to enhance the practice of teaching in the profession, improve faculty development incentives, and develop curricula and strategies that foster lifelong learning and clinical inquiry skills in student nurses.

For more report highlights, see To order copies of Educating Nurses: A Call for Radical Transformation, see

Moving to a More Highly Qualified Nursing Workforce

Quality patient care hinges on having a well-educated nursing workforce. A growing body of research clearly shows that lower patient mortality rates, fewer medication errors, and positive care outcomes are all linked to nurses prepared at the baccalaureate and graduate degree levels. The research is compelling:

  • In studies conducted in 2003 and 2008, Dr. Linda Aiken and colleagues at the University of Pennsylvania found 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. A 10% increase in the proportion of nurses holding baccalaureates decreased the risk of patient death and failure to rescue by up to 5%.
  • In a 2008 study, University of Michigan professor Dr. Christopher Friese and colleagues examined the impact of nursing education level and the practice environment on outcomes for hospitalized cancer patients undergoing surgery. Nurses prepared at the baccalaureate-level were linked with lower mortality and failure-to-rescue rates.
  • Researchers at the University Toronto found that hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. The findings indicated that a 10% increase in the proportion of baccalaureate prepared nurses was associated with 9 fewer deaths for every 1,000 discharged patients.

AACN strongly believes that nurses with baccalaureate degrees are better equipped to meet the demands placed on today's RN. Nurse executives, federal agencies, the military, leading nursing organizations, healthcare foundations, magnet hospitals, and minority nurse advocacy groups all recognize the unique value that baccalaureate-prepared nurses bring to the practice setting. AACN is committed to working collaboratively with partners across the educational continuum to raise the education level of the RN workforce with the goal of enhancing both clinical competency and care delivery.

“Encouraging all nurses to continue their education is an important step toward ensuring patient safety in an often fragmented healthcare system,” said Dr. Raines. “Hundreds of articulation agreements and nursing degree completion programs are already in place to facilitate the educational advancement of RNs. To maximize these resources, all stakeholders must come together to make transforming the nation’s nursing education system a national priority.”

For more research and information on enhancing the education level of nurses, see:

AACN Position Statements:

The Baccalaureate Degree in Nursing as Minimal Preparation for Professional Practice

The Preferred Vision of the Professoriate in Baccalaureate and Graduate Nursing Programs

AACN Fact Sheets:

The Impact of Education on Nursing Practice

Creating a More Highly Qualified Nursing Workforce

Articulation Agreements Among Nursing Education Programs

Degree Completion Programs for Registered Nurses

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The American Association of Colleges of Nursing (AACN) is the national voice for university and four-year college education programs in nursing. Representing more than 640 member schools of nursing at public and private institutions nationwide, AACN's educational, research, governmental advocacy, data collection, publications, and other programs work to establish quality standards for bachelor's- and graduate-degree nursing education, assist deans and directors to implement those standards, influence the nursing profession to improve health care, and promote public support of baccalaureate and graduate nursing education, research, and practice. Website:



Robert Rosseter, 202-463-6930, ext. 231