Nurses' Educational Preparation and Patient Outcomes

RNs with baccalaureate degrees provide the best post-surgical care.

There are three routes of education for becoming a Registered Nurse (RN): by completing a 3-year diploma (non-degree) program, completing a 2-year Associate’s Degree program, or completing a 4-year Baccalaureate program, which leads to the BSN degree. Nurses in practice have been disputing the pros and cons of each type of educational preparation for years.

To determine if and how patient outcomes are linked to educational preparation, researchers from the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy Research surveyed 42,000 RNs in Pennsylvania in 1999 and 25,000 in 20006. They found that a ten-point increase in the percentage of BSN nurses within a hospital was associated with an average reduction of 2.12 deaths for every 1,000 patients, and for a subset of patients with complications, an average reduction of 7.47 deaths per 1,000 patients. They concluded that if all 134 hospitals in the study had increased the percentage of their nurses with baccalaureate degrees by ten points during the study’s time period, approximately 500 deaths of patients who underwent general, orthopedic, and vascular surgery could have been prevented. Although the scope of the study was limited to post-surgical care and outcomes, the findings provide support for efforts to increase the production and employment of nurses with BSN degrees.


Kutney-Lee A, Sloane DM, Aiken LH. An Increase In The Number Of Nurses With Baccalaureate Degrees Is Linked To Lower Rates Of Postsurgery Mortality. Health Affairs. 2013; 32 (3): 579-586.

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