BSN in 10-What Every Nurse Needs to Know
Barbara Zittel, RN, Ph.D.
Trends in Nursing Education
100%
Diploma
Associate's
80%
Bachelor's/Master's
60%
40%
20%
0%
Before 1960
1960s
1970s
1980s
1990s
2000s
Each year, out of 100 RNs seeking
NYS licensure, 62 are Associate and
38 are Baccalaureate Graduates
Graduates from basic nurse
baccalaureate programs are over
3 times more likely to obtain graduate
degrees
Initial BSN
Graduates
Initial ADN
Graduates
Adapted from: Aiken, Cheung, Olds. 2009. Health Affairs 28(4)
RESEARCH
FINDINGS
Multiple Researchers have demonstrated a significant relationship
between nursing education and improved patient outcomes
As Nurse Education Increases,
Patient Mortality Decreases.
95
90
85
80
Aiken, 2003, JAMA
90
deaths
in
1,000
patients
75
84
deaths
in
1,000
patients
70
76
deaths
in
1,000
patients
65
20%
40%
60%
Education
(Percentage of hospital nurses with BS degrees.)
232,342 patients from 168 PA non-federal adult general hospitals.
NYS 30 day mortality surgical discharges
NYS Thirty Day Surgical Mortality
Preventable with each 10% Increase in
BS Prepared Nurses
35,000
30,000
25,000
20,000
Deaths
Prevented Deaths
15,000
10,000
5,000
0
Total
Deaths
5%
10%
15%
20%
Percentage of Decreased Deaths
with each 10% increase in BS Prepared Nurses
Estabrooks, et al. (2005)
Replication of Aiken study in 18,142
patients in 49 hospitals in Alberta, Canada
with identical results
Hospitals with a higher proportion of BSN RNs
experienced lower rates of 30-day patient mortality
Tourangeau (2007)
• Study of 46, 993 patients
• Demonstrated 9 fewer deaths per
1,000 discharges for every 10%
increase in BS prepared nurses
Blegen & Goode (2009)
• Longitudinal study of 21 US hospitals
over 84 quarters
• In hospitals with a higher proportion of
BS educated nurses:
– Lower rates of CHF mortality
– Fewer Hospital Acquired Pressure
Ulcers
– Lower Rates of Failure to Rescue
– Shorter Hospitalizations
Changes in the
Health Care Environment
*Advances in science
*Increasingly diverse population
*Care over continuum - medical homes
*Value Based Purchasing – paying for outcomes
These factors have resulted in increased patient complexity,
accelerating the need for nurses with broader skills and knowledge to
manage & coordinate care of more diverse and
challenging populations across all settings.
Transformation of Nursing Education
Canada:
New RNs must be BS prepared
European
Union:
BS required
Philippines:
BSN Required
Since 1988
Turkey:
Thailand:
BSN required BS required
since 1997
Australia:
BSN Required
Since 1992
Minimum Entry-Level Education Requirements for
Select Licensed Health Professions
Midwifery
Nurse Practitioner
Occupational Therapy
Speech Lang. Path.
Audiology
Lic. Clin. Soc. W.
Lic. Masters Soc. W.
RN
Athletic Training
Diploma/
Associate
BS
Lic. Mental Hlth Couns.
Master’s
Physical Therapist
Medicine
Dentistry
Podiatry
Psychology
Pharmacy
Doctorate
2010 Carnegie Foundation report
Educating Nurses: A Call for
Radical Transformation
(Patricia Benner, et al.) calls for
the BS degree in nursing for
licensure
2008-RWJF-IOM
Collaboration
Chaired by former
Department of Health and Human Services
Secretary Donna Shalala
2010- Release of the Report
October 2010 Report
Recommends that 80% of RNs be prepared with the BS degree by
2020.
Question 4.
The “BS in 10” proposal would close associate
degree programs because every RN would need to
obtain a BS degree after the bill is passed into law.
1. True
2. False
Question 5.
The “BS in 10” proposal would require every
currently licensed RN to obtain a BS degree within
10 years after the bill is passed into law.
1. True
2. False
PROPOSAL
Would permit persons with a diploma or
associate degree in nursing,
seeking future licensure, to obtain that
licensure but,
would require such applicants to obtain
a BS degree in nursing
10 years after that initial licensure.
PROPOSAL
Grand parenting of all currently licensed (RNs);
Time to permit all students on a waiting list or enrolled in associate
or diploma programs to complete their studies and be grand parented
Provisions that would place a Registered Nurse’s license on
“hold” if the baccalaureate degree is not obtained in 10 years.
Opportunity for an extension beyond 10 years, for extenuating
circumstances, as determined by the Department.
Current Status of the Board’s Motion
NYONE takes Lead in Seeking
Legislative Support
Assembly Bill # ?? Sponsor??
Senate Bill # ?? Sponsor??
Benefits to New York
*Project 6,000 fewer surgical deaths annually when 60% of nurses are
prepared at the BS level.
*Project a 10% reduction in the 200,000 hospital acquired pressure
ulcers each year. The published additional length of stay from hospital
acquired pressure ulcers is 3.98 days, thus the potential savings is 17.5
million dollars annually.
*With the reduction of the Length of Stay (LOS) by 0.2 days there is a
potential capacity for 400,000 additional patient days.
*Every 1% reduction in RN turnover saves $12.9 million statewide.
The Plight of New Graduates
Many hospitals are responding to research and
Magnet expectations by requiring their nursing staff to
hold the BS in Nursing degree.
Perceived Problems/Concerns
STATEMENT
If I get my BS I will be removed from
bedside nursing.
I’m content at what I’m doing why should I
go on to the BS degree?
I’m just as good as any BS prepared nurse!
RESPONSE