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Variations in nursing baccalaureate education and 30-day inpatient surgical mortality

  • Joshua Porat-Dahlerbruch
    Correspondence
    Corresponding author: Joshua Porat-Dahlerbruch, Department of Health Systems Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva 841051, Israel.
    Affiliations
    Department of Health Systems Management, Guilford Glazer Faculty of Business and Management and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA

    Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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  • Linda H. Aiken
    Affiliations
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA

    Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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  • Karen B. Lasater
    Affiliations
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA

    Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
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  • Douglas M. Sloane
    Affiliations
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA
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  • Matthew D. McHugh
    Affiliations
    Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA

    Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA
    Search for articles by this author
Published:November 08, 2021DOI:https://doi.org/10.1016/j.outlook.2021.09.009

      Highlights

      • Higher proportions of BSN nurses associated with reduced odds of patient mortality.
      • Link between more BSN nurses and improved outcomes not dependent on BSN pathway.
      • Evidence for increasing BSN workforce via initial and RN to BSN completion pathways.
      • Discussion of implications for diversity in the nursing workforce.

      Abstract

      Background

      In 2010, the IOM recommended an increase in the proportion of bachelor's-prepared (BSN) nurses to 80% by 2020. This goal was largely based on evidence linking hospitals with higher proportions of BSN nurses to better patient outcomes. Though, evidence is lacking on whether outcomes differ by a hospital's composition of initial BSN and transitional RN-to-BSN nurses.

      Purpose

      The purpose of this study is to determine whether risk-adjusted odds of surgical mortality are associated with a hospital's proportion of initial BSN and transitional RN-to-BSN nurses.

      Methods

      Logistic regression models were used to analyze cross-sectional data of general surgical patients, nurses, and hospitals in four large states in 2015 to 2016.

      Findings

      Higher hospital proportions of BSN nurses, regardless of educational pathway, are associated with lower odds of 30-day inpatient surgical mortality.

      Discussion

      Findings support promoting multiple BSN educational pathways to reach the IOM's recommendation of at least an 80% BSN workforce.

      Keyword

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