The calculus of nursing education and patient outcomes
Thursday, March 13, 2014
With the publication of a new study in The Lancet in February, it appears that the call for more baccalaureate-prepared nurses just became louder, and the results of said study appear to carry a great deal of weight in both the academic and clinical worlds.
Using discharge data from more than 400,000 hospitalized European patients, this well-received study demonstrates that increasing a hospital nurse's workload by only one patient leads to a 7 percent increase in the chances that a patient will die within 30 days of admission. The study also revealed that a 10 percent increase in the number of nurses with a bachelor's degree decreases the likelihood of death by 7 percent.
Based on reactions to the study, these numbers are speaking loud and clear.
Positive reactions echo the past
Reactions to the study have been overwhelmingly positive. Organizations including the American Association of Colleges of Nursing (AACN) are clearly applauding the results, echoing calls from a variety of sources that increased education for nurses has a universally positive impact.
Interestingly, a 2003 study lauded by the AACN came to the same conclusion, demonstrating just as irrefutably that an increase in bachelor's-prepared nurses significantly decreases patient mortality.
A number of similar studies over the years have all basically come to the same conclusion, thus consensus appears to be growing that encouraging nurses to pursue education at the baccalaureate level — or higher — is in the interest of everyone.
Patient outcomes and satisfaction loom large
With the results of the aforementioned study being widely disseminated through online news services, there is little doubt that consumers will take notice that the educational level and workload of nurses can profoundly impact their chances of survival after hospitalization. And if consumers begin to fully understand the consequences, they may themselves begin to demand a higher level of education in the nurses from whom they receive care.
Since the implementation of HCAHPS (patient satisfaction) scores and their direct connection with reimbursement for medical care, the power of consumer demand and consumer knowledge appears ready to grow exponentially.
Education and its cost
Speak with most any nurse interested in furthering his or her education — and the cost of that education — is likely to be a subject of intense consideration. Additional student debt is a serious matter for most anyone, and nurses are not immune to the frequently prohibitive cost of higher education.
Through programs like The Nurse Corps Loan Repayment Program under the auspices of the U.S. Department of Health and Human Services, the government has increased the availability of loan forgiveness and consolidation for those seeking careers in nursing. The Nursing Education Loan Repayment Program is another government undertaking with the laudable aim of encouraging Americans to pursue a nursing career.
Many nurses and would-be nurses are still wary of student loans, despite promises of government support. Thus, it's evident that more outreach is needed in order for trust in such programs to grow. That trust, in turn, would likely lead to an increase in the number of nurses with the educational experience to which we are now encouraging them to aspire.
Meanwhile, university education in many European countries is essentially free thanks to government subsidies. This begs the question of whether our European counterparts will achieve a significant increase in baccalaureate-prepared nurses more easily and quickly than those of us on this side of the Atlantic, where government support for higher education is much less robust.
Conclusions about nursing education
Multiple studies have clearly shown that the benefits of increased nursing education are many. Apparently, we can now safely conclude that lives can be saved and outcomes improved when nurses have lesser workloads and higher levels of education.
Concurrently, economic realities in the United States lead many nurses to eschew pursuing further studies and higher degrees, even as the government's programs to make those endeavors more feasible frequently fall on deaf ears.
It will take a concerted effort and many strategic partnerships to steer the ship of the nursing profession in the direction of an increase in nurses achieving baccalaureate status. Cries for legislation that mandates a bachelor's degree for all nurses have arisen from time to time, but there are plenty of individuals and institutions that have, and will likely continue to, push back against such demands.
It's clear that patient outcomes benefit from more highly educated nurses, and it's possible that consumer demand (and institutional buy-in) may begin to turn the tide. It remains to be seen how this particular aspect of healthcare will develop over time, and it also remains to be seen if nurses will themselves embrace the educational and clinical realities that these studies have revealed.
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