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Health Aff (Millwood). 2019 Jul;38(7):1087-1094. doi: 10.1377/hlthaff.2018.05064.

In Hospitals With More Nurses Who Have Baccalaureate Degrees, Better Outcomes For Patients After Cardiac Arrest.

Author information

1
Jordan M. Harrison ( joharr@nursing.upenn.edu ) is a research fellow in the Center for Health Outcomes and Policy Research, a National Clinical Scholar in the Perelman School of Medicine, and an associate fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania, in Philadelphia.
2
Linda H. Aiken is the Claire M. Fagin Leadership Professor of Nursing, a professor of sociology, director of the Center for Health Outcomes and Policy Research, and a senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania.
3
Douglas M. Sloane is an adjunct professor at the Center for Health Outcomes and Policy Research, University of Pennsylvania.
4
J. Margo Brooks Carthon is an associate professor in the Center for Health Outcomes and Policy Research and a senior fellow in the Leonard Davis Institute of Health Economics, University of Pennsylvania.
5
Raina M. Merchant is an associate professor of emergency medicine in the Perelman School of Medicine, director of the Penn Medicine Center for Digital Health, and a senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania.
6
Robert A. Berg is a professor of anesthesiology and critical care at the Children's Hospital of Philadelphia.
7
Matthew D. McHugh is a professor of nursing, the Independence Chair for Nursing Education, associate director of the Center for Health Outcomes and Policy Research, and a senior fellow in the Leonard Davis Institute of Health Economics, all at the University of Pennsylvania.
8
The American Heart Association's Get With the Guidelines-Resuscitation Investigators are acknowledged at the end of the article.

Abstract

In 2010, prompted by compelling evidence that demonstrated better patient outcomes in hospitals with higher percentages of nurses with a bachelor of science in nursing (BSN), the Institute of Medicine recommended that 80 percent of the nurse workforce be qualified at that level or higher by 2020. Using data from the American Heart Association's Get With the Guidelines-Resuscitation registry (for 2013-18), RN4CAST-US hospital nurse surveys (2015-16), and the American Hospital Association (2015), we found that each 10-percentage-point increase in the hospital share of nurses with a BSN was associated with 24 percent greater odds of surviving to discharge with good cerebral performance among patients who experienced in-hospital cardiac arrest. Lower patient-to-nurse ratios on general medical and surgical units were also associated with significantly greater odds of surviving with good cerebral performance. These findings contribute to the growing body of evidence that supports policies to increase access to baccalaureate-level education and improve hospital nurse staffing.

KEYWORDS:

Nursing; acute care hospitals; education; hospital medical staff; in-hospital cardiac arrest; nurses; patient outcomes

PMID:
31260358
PMCID:
PMC6681904
[Available on 2020-07-01]
DOI:
10.1377/hlthaff.2018.05064

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