Study touts benefits of four-year nursing degree

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Hospitals that employ mostly nurses with four-year bachelor’s degrees — as opposed to mostly registered nurses — will likely see improved patient outcomes and reduced costs, according to a new study.

For years, experts have recommended increasing the proportion of nurses holding bachelor of science in nursing degrees — and Maryland’s nursing community is largely on board with that goal — but a study published this month provided the first economic analysis of doing so.

That study, published in the journal “Medical Care,” found that patients who received at least 80 percent of their care from BSN-prepared nurses reduced by 19 percent their chances of being readmitted to the hospital.

Those patients also stayed in the hospital for slightly shorter periods of time than patients who were treated primarily by RNs, who go through two-year training programs. Further, the study found that a 10 percent increase in the percentage of care by BSN-holding nurses was associated with a 10 percent reduction in a patient’s odds of dying.

“When we looked at patients in the same hospital, who were hospitalized on the same unit with the same diagnosis, patients who received more than 80 percent of nursing care from BSN-educated nurses tended to do better,” Olga Yakusheva, one of the lead researchers and an associate professor of nursing at the University of Michigan, said in a statement.

The study was funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative.

The researchers also found that even though BSN-holding nurses are paid more than RNs, the care they provide can result in significant cost-savings for the hospital. Those savings actually outweighed the burden of paying higher salaries, according to the research.

“It doesn’t mean nurses [with associate degrees] aren’t good at their jobs — they absolutely are,” said Katharine Cook, dean of the School of Nursing at Notre Dame of Maryland University. “But the research is showing that if you have a BSN degree, you’re able to approach problems in a different way.”

Hospitals are paying attention to the research, too.

“What I’m hearing over and over is that hospitals in Maryland are hiring the BSN-prepared nurses and not hiring the [associate degree] nurses as much.”

The idea of encouraging nurses to seek higher degrees is not new.

In 2010, the Institute of Medicine published a prominent report — called “The Future of Nursing: Leading Change, Advancing Health” — that assessed the state of the profession and laid out a blueprint for changes.

The report made multiple recommendations for how to improve nursing education and better integrate nurses into the post-Affordable Care Act health care landscape. It set a goal that 80 percent of nurses should hold a BSN degree by 2020. Currently, only about 55 percent do, according to the most recent estimate.

But nursing schools have taken notice of the new target. In Maryland, several schools have explicitly embraced it by working to boost enrollment in their baccalaureate nursing programs or adding new options, like online programs.

Frostburg State University has significantly grown its RN-to-BSN program, which is for practicing nurses who want to get the higher degree. Heather Gable, chair of FSU’s nursing department, said the program grew from eight students in 2009 to about 270 students during the 2014 spring semester.

Notre Dame of Maryland launched its four-year BSN program in 2010 to serve non-nurses who want to receive comprehensive training. Officials plan to increase that program’s class size by 50 students each year.