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Study: More BSN nurses means lower mortality rates


When hospitals hire more nurses with four-year degrees, patient deaths following common surgeries decrease, according to a study.

Researchers with the University of Pennsylvania School of Nursing’s Center for Health Outcomes and Policy Research posited that if all 134 Pennsylvania hospitals involved in the study had increased the proportion of nurses with four-year degrees by 10 percentage points, the lives of about 500 patients who had undergone general, vascular or orthopedic surgery might have been saved.

Among the hospitals studied, actual increases of 10 percentage points in the proportion of BSN-prepared nurses between 1999 and 2006 saved about two lives for every 1,000 patients treated on average, said Ann Kutney-Lee, RN, PhD, the study’s lead author and a professor at Penn Nursing.

“This adds to the importance of public policies to help direct a substantial shift toward the production of nurses with baccalaureates in nursing,” Kutney-Lee, also a senior fellow at the Leonard Davis Institute of Health Economics, said in a news release. “Nursing is both high-touch and high-tech, requiring honed critical thinking skills in our complicated healthcare system.”

The authors did not find such reductions in mortality connected to other types of variations, such as staffing levels, skills or years of experience in the nursing staff. Although the study did not pinpoint why more patients survive surgeries, previous work in the Center found that better-prepared nurses offer higher levels of surveillance of patients, noticing subtle shifts while there is time to intervene in patients’ conditions that can lead to death from complications.

“As part of their practice, nurses are responsible for the continual assessment and monitoring of a patient’s condition, identifying changes that could indicate clinical deterioration and initiating interventions when necessary,” Kutney-Lee said.

The study appears in the March issue of Health Affairs and was funded by the Agency for Healthcare Research and Quality, the National Institute of Nursing Research of the National Institutes of Health, and the Robert Wood Johnson Foundation. The study abstract is available at


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