Employing Academic Nurses Leads to Fewer Patient Deaths

A new study shows that hospitals that hire nurses with four-year baccalaureate degrees suffer fewer patient deaths following common surgeries.

Researchers at the University of Pennsylvania (Philadelphia, USA) used the Pennsylvania nurse survey and patient discharge data, which included 42,000 registered nurses (RN) surveyed in Pennsylvania (USA) in 1999, and 25,000 surveyed in 2006. The researchers found that a ten-point increase in the percentage of nurses holding a baccalaureate degree in nursing within a hospital was associated with an average reduction of 2.12 deaths for every 1,000 patients; for a subset of patients with complications, an average reduction of 7.47 deaths occurred per 1,000 patients.

The researchers further estimated that if all 134 hospitals included in the study had increased the percentage of their nurses with baccalaureates by ten points during the study period, some 500 deaths among general, orthopedic, and vascular surgery patients might have been prevented. The researchers added that currently, only 45% of nurses in the United States have baccalaureate degrees, according to the most recent data available (2008). The study was published in the March 2013 issue of Health Affairs.

“This adds to the importance of public policies to help direct a substantial shift toward the production of nurses with baccalaureates in nursing,” said lead author Professor of nursing Ann Kutney-Lee, PhD, RN, of the School of Nursing Center for Health Outcomes and Policy Research. “Nursing is both high-touch and high-tech requiring honed critical thinking skills in our complicated healthcare system.”

Currently, RNs have obtained a four-year (baccalaureate degree), a two-year (associate's) degree, or graduated from a hospital-based diploma school. Licensed practical nurses (LPN) also practice at the bedside with a one-year degree. A recent Institute of Medicine (IOM; Washington DC, USA) report has called for registered nurses to achieve higher levels of education, but health care policy makers and others have so far limited evidence to support a substantial increase in the number of nurses with baccalaureate degrees.

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