the following is from the aacn
recognizing differences among nursing program graduates
there is a growing body of evidence that shows that bsn graduates bring unique skills to their work as nursing clinicians and play an important role in the delivery of safe patient care.
*in an article published in health services research in august 2008 that examined the effect of nursing practice environments on outcomes of hospitalized cancer patients undergoing surgery, dr. christopher friese and colleagues found that nursing education level was significantly associated with patient outcomes. nurses prepared at the baccalaureate-level were linked with lower mortality and failure-to-rescue rates. the authors conclude that “moving to a nurse workforce in which a higher proportion of staff nurses have at least a baccalaureate-level education would result in substantially fewer adverse outcomes for patients.”
*in a study released in the may/june 2008 issue of the journal of nursing administration, dr. linda aiken and her colleagues confirmed the findings from their landmark 2003 study (see below) which show a strong link between rn education level and patient outcomes. titled “effects of hospital care environment on patient mortality and nurse outcomes,” these leading nurse researchers found that every 10% increase in the proportion of bsn nurses on the hospital staff was associated with a 4% decrease in the risk of death.
*in the january 2007 issue of the journal of advanced nursing, a new study is titled “impact of hospital nursing care on 30-day mortality for acute medical patients” found that baccalaureate-prepared nurses have a positive impact on lowering mortality rates. led by dr. ann e. tourangeau, a research team from the university of toronto and the institute for clinical evaluative sciences in ontario, canada, studied 46,993 patients admitted to the hospital with heart attacks, strokes, pneumonia and blood poisoning. the authors found that: "hospitals with higher proportions of baccalaureate-prepared nurses tended to have lower 30-day mortality rates. our 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."
*in a study published in the march/april 2005 issue of nursing research, dr. carole estabrooks and her colleagues at the university of alberta found that baccalaureate prepared nurses have a positive impact on mortality rates following an examination of more than 18,000 patient outcomes at 49 canadian hospitals. this study, titled the impact of hospital nursing characteristics on 30-day mortality, confirms the findings from dr. linda aiken's landmark study in september 2003.
*in a study published in the september 24, 2003 issue of the journal of the american medical association (jama), dr. linda aiken and her colleagues at the university of pennsylvania identified a clear link between higher levels of nursing education and better patient outcomes. this extensive study 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. in hospitals, a 10 percent increase in the proportion of nurses holding bsn degrees decreased the risk of patient death and failure to rescue by 5 percent. the study authors further recommend that public financing of nursing education should aim at shaping a workforce best prepared to meet the needs of the population. they also call for renewed support and incentives from nurse employers to encourage registered nurses to pursue education at the baccalaureate and higher degree levels.
*evidence shows that nursing education level is a factor in patient safety and quality of care. as cited in the report when care becomes a burden released by the milbank memorial fund in 2001, two separate studies conducted in 1996 - one by the state of new york and one by the state of texas - clearly show that significantly higher levels of medication errors and procedural violations are committed by nurses prepared at the associate degree and diploma levels as compared with the baccalaureate level. these findings are consistent with findings published in the july/august 2002 issue of nurse educator magazine that references studies conducted in arizona, colorado, louisiana, ohio and tennessee that also found that nurses prepared at the associate degree and diploma levels make the majority of practice-related violations.
*chief nurse officers (cno) in university hospitals prefer to hire nurses who have baccalaureate degrees, and nurse administrators recognize distinct differences in competencies based on education. in a 2001 survey published in the journal of nursing administration, 72% of these directors identified differences in practice between bsn-prepared nurses and those who have an associate degree or hospital diploma, citing stronger critical thinking and leadership skills.
*studies have also found that nurses prepared at the baccalaureate level have stronger communication and problem solving skills (johnson, 1988) and a higher proficiency in their ability to make nursing diagnoses and evaluate nursing interventions (giger & davidhizar, 1990).
*research shows that rns prepared at the associate degree and diploma levels develop stronger professional-level skills after completing a bsn program. in a study of rn-to-bsn graduates from 1995 to 1998 (phillips, et al., 2002), these students demonstrated higher competency in nursing practice, communication, leadership, professional integration, and research/evaluation.