ADN vs. BSN - patient mortality rates

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I came across an article that was talking about the importance of a baccalaureate degree in nursing. Here is a quote from their article, "Several studies have demonstrated an inverse relationship between the proportion of BSN nurses and mortality of the hospitalized patient.In other words, they found that as the proportion of baccalaureate-degree registered nurses increased in hospitals, patient deaths decreased."

I have my ADN degree, the college I graduated from is highly regarded and better prepares their students than the BSN program down the road. Also, the ADN program I graduated from does far more clinicals than BSN program down the road, and in my opinion that is better at preparing student nurses for starting their career. I am not speaking for all the other ADN or BSN programs in the country. I just thought this would make an interesting topic and would like to hear everyone's opinion on this subject.

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Can you link the article? It is difficult to evaluate the evidence without the actual study.

This is an old, exhausted debate. I saw a thread earlier today on AN discussing this very issue...something about eliminating the differing degrees/education among nurses.

I look forward to the (probably imaginary) day when nurses simply work together for the good of their patients, each doing what they do best and helping each other in areas where they struggle.

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I came across an article that was talking about the importance of a baccalaureate degree in nursing. Here is a quote from their article, "Several studies have demonstrated an inverse relationship between the proportion of BSN nurses and mortality of the hospitalized patient.In other words, they found that as the proportion of baccalaureate-degree registered nurses increased in hospitals, patient deaths decreased."

Please post either a link or the article citation.

I have my ADN degree, the college I graduated from is highly regarded and better prepares their students than the BSN program down the road. Also, the ADN program I graduated from does far more clinicals than BSN program down the road, and in my opinion that is better at preparing student nurses for starting their career. I am not speaking for all the other ADN or BSN programs in the country. I just thought this would make an interesting topic and would like to hear everyone's opinion on this subject.

Do you have anything other than your opinion that one program provides a better preparation than the other?

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Do you have anything other than your opinion that one program provides a better preparation than the other?

An excellent point. If you never went to the BSN program down the street, you cannot objectively say that one program better prepares you than another. Even as far as school ratings go, ratings would be insufficient as degree of preparation for the workplace is more of a qualitative value versus quantitatitve.

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Specializes in Critical Care.

There are several studies that link the shared characteristics of Hospitals with a high proportion of BSN's with lower mortality, but none have really directly linked a BSN level education with lower mortality. Proportions of BSN's are higher in larger, research and teaching hospitals which also tend to have lower patient ratios and significantly more patient care support. We know all of these characteristics can decrease patient mortality, so how much of the reduced mortality is due to better patient ratios, for instance, and how much is due to higher average level of education has never been well defined in research. These studies do adjust for these characteristics but there's been a lot of controversy as to whether or not these adjustments fall short.

I'd love to be able to say my patient's are less likely to die because I have a BSN, but at the same time without a study that more closely resembles a randomized and controlled study I don't think we can say that with certainty, there is some data that might suggest that, but it's not something we "know".

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.

sigh...this argument has been going on as long as I have been a nurse. bth_beatdedhorse.gif

This argument has been going on since the inception of this site.....and continues today. If you use the google search que box in the upper right hand corner and type in ADN vs BSN you will find discussion that lasts for pages and pages...or just click on the link provided.

The are good and bad ADN and BSN programs. I have my own theories on why there is the big push for BSN is happening...mostly monetary by the schools to keep students indentured by thousands to hundreds of thousands of dollars in debt AND by facilities to keep the market saturated by an employee loaded with debt to keep them quiet and compliant...and a market saturated with competent individuals has a lower salary/benefit ratios thereby lowering labor costs of the facility.

The benefit of BSN staff? The studies have all been done by those perpetuating the myth that the BSN provides lower mortality but as MunoRN points out these facilities have a higher BSN population as they are academic facilities .....

MunoRN There are several studies that link the shared characteristics of Hospitals with a high proportion of BSN's with lower mortality, but none have really directly linked a BSN level education with lower mortality. Proportions of BSN's are higher in larger, research and teaching hospitals which also tend to have lower patient ratios and significantly more patient care support. We know all of these characteristics can decrease patient mortality, so how much of the reduced mortality is due to better patient ratios, for instance, and how much is due to higher average level of education has never been well defined in research. These studies do adjust for these characteristics but there's been a lot of controversy as to whether or not these adjustments fall short.

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While I agree that I think nursing needs to have one entry level of education it is unlikely to happen any time soon for you can't bankrupt these community colleges with these programs....case in point.... there are diploma (hospital based schools) still functioning today, however few there are. The discussion of BSN entry has been discussed when I was in school 35 years ago.

It is also of note that with a saturated market that facilities can afford to be choosy and seem to be pushing the agenda of BSN education by having a preference for hiring the BSN grad. This thread will have plenty of responses for this discussion draws responses like a light bulb draws moths. But is one degree truly make a superior nurse? NO....I don't think so......it is the superior program that produces the superrior nurse. I have seen both graduates out shine the other depending on the quality of the program.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I work at a top 10 hospital in the US. WAY less than 80% have BSN. Our acuity is higher, we have some of the sickest people in the country here and us ADNers seem to be doing ok.

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Specializes in ICU + Infection Prevention.
I work at a top 10 hospital in the US. WAY less than 80% have BSN. Our acuity is higher, we have some of the sickest people in the country here and us ADNers seem to be doing ok.

For surgery, big and famous hospitals aren't always the best | Reuters

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Specializes in Dialysis, Psych.

It's not all for ADNers to do OK!!! As nurses, we have to practice at the highest professional level. Please that this from a BSN who worked his way from LPN to ADN, and now BSN.

I am now embarking to my journey to becoming MSN, and I think that it is great to stay current with nursing knowledge. In addition nurses should pride themselves in continuing higher education. I understand that it takes a lot of sacrifices to achieve higher education goals.

Good luck in your endeavors.

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There are several studies that link the shared characteristics of Hospitals with a high proportion of BSN's with lower mortality, but none have really directly linked a BSN level education with lower mortality. Proportions of BSN's are higher in larger, research and teaching hospitals which also tend to have lower patient ratios and significantly more patient care support. We know all of these characteristics can decrease patient mortality, so how much of the reduced mortality is due to better patient ratios, for instance, and how much is due to higher average level of education has never been well defined in research. These studies do adjust for these characteristics but there's been a lot of controversy as to whether or not these adjustments fall short.

I'd love to be able to say my patient's are less likely to die because I have a BSN, but at the same time without a study that more closely resembles a randomized and controlled study I don't think we can say that with certainty, there is some data that might suggest that, but it's not something we "know".

Exactly.

Correlation of data does not equal causation. Our highly educated collegues who've taken statistics should be well aware of this.

For example:

There's a study that clearly shows a correlation between the sale of ice cream and the incidence of child drownings. It's solid data that shows there's a concrete and undeniable correlation between the two pieces of data. And it's true in every community surveyed, across the board. Sounds like it "proves" a link between ice cream consumption and drowning, right?

Well, no, it's simply correlation of two unrelated pieces of data that are affected by a common third piece of data. Think about it. When do people eat more ice cream? When it's hot. And when are people more likely to go swimming.....

Theres a third factor never discussed in the BSN/ADN debate , too. As MunoRN pointed out, hospitals that have a higher percentage of BSNs also tend to have better staffing ratios, better equipment, and better access to medical specialists.

Indeed, it could be argued that all these studies prove is that hospitals with better resources have better outcomes. Not exactly an earth shattering discovery.

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Specializes in Oncology/Haemetology/HIV.

There are several problems with the methodology of the report. But the most apparent one deals with the type of cases taken. I

In the smaller hospitals that I have worked in, the more serious cases, the most difficult cases, and the more debilitated PTs often got turfed to the "Big name" hospital. Or when the local MD gave the pt/family bad news on a case that was beyond treatment, they demand transfer to the "Big Name" facility. Whereupon, Big Name tells them that they are untreatable.

Now, currently working at one of the Big Names listed, we routinely get PTs that have either been mismanaged at an outside hospital, or treatment put off for weeks, or that has disease that has not responded to treatment. Often the patient will be completely untreatable and dying when we receive them. We also get cases, which are grossly misrepresented sent to us for research protocols. The sending MD will send a patient that obviously cannot undergo treatment and often cannot even be legally consented for research chemo. Then we look like the bad guy for saying that we cannot ethically treat them, and the sending facility will not accept them back.

In many areas, the local community will often not care for AML leukemia PTs, preferring to transfer to an academic center that is better equipped for AML care. With a disease that has a mortality rate of 26-32%, the academic center will have a higher death rate than the facilities that do keep and treat AML. And initial induction will keep pt in for a month minimum.

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Specializes in Acute Care Psych, DNP Student.

Individual nurses will vary regardless of educational level. Overall, more education is better. I started as an ADN-RN and finished the BSN later. I support BSN for entry to practice.

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