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Baccalaureate Education in Nursing and Patient Outcomes

Blegen, Mary A. PhD, RN, FAAN; Goode, Colleen J. PhD, RN, FAAN; Park, Shin Hye PhD, RN; Vaughn, Thomas PhD; Spetz, Joanne PhD, FAAN

JONA: The Journal of Nursing Administration: February 2013 - Volume 43 - Issue 2 - p 89–94
doi: 10.1097/NNA.0b013e31827f2028

OBJECTIVES: The aim of this study was to examine the effects of registered nurse (RN) education by determining whether nurse-sensitive patient outcomes were better in hospitals with a higher proportion of RNs with baccalaureate degrees.

BACKGROUND: The Future of Nursing report recommends increasing the percentage of RNs with baccalaureate degrees from 50% to 80% by 2020. Research has linked RN education levels to hospital mortality rates but not with other nurse-sensitive outcomes.

METHODS: This was a cross-sectional study that, with the use of data from 21 University HealthSystem Consortium hospitals, analyzed the association between RN education and patient outcomes (risk-adjusted patient safety and quality of care indicators), controlling for nurse staffing and hospital characteristics.

RESULTS: Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay.

CONCLUSION: The recommendation of the Future of Nursing report to increase RN education levels is supported by these findings.

Author Affiliations: Professor Emerita (Dr Blegen); Professor (Dr Spetz), School of Nursing, University of California, San Francisco; Professor (Dr Goode), College of Nursing, University of Colorado at Denver; Research Associate (Dr Park), School of Nursing, University of Kansas Medical Center; Associate Professor (Dr Vaughn), College of Public Health, University of Iowa.

Funding: Supported by an Interdisciplinary Nursing Quality Research Initiative grant from the Robert Wood Johnson Foundation and with assistance from the University HealthSystem Consortium.

The authors declare no conflicts of interest.

Correspondence: Dr Blegen, 1778 So Tucson St, Aurora, CO 80012 (

© 2013 Lippincott Williams & Wilkins, Inc.