AACN Applauds Study Confirming Link Between Nursing Education, Patient Mortality Rates; Education is Key to Patient Safety, Preventing Deaths

9/23/2003

From: Robert Rosseter of the American Association of Colleges of Nursing, 202-463-6930, ext. 231; rrosseter@aacn.nche.edu

WASHINGTON, Sept. 23 -- 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 4 to 1.

-- 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.

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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 570 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.



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