Influence of Bedside Nurse Education Level on Patient Mortality and Failure to Rescue

Influence of Bedside Nurse Education Level on Patient Mortality and Failure to Rescue

Bibliography

Name: Kimberly Barcus

Rank: MAJ

Presenter/Poster: Poster

Year: 2017

Abstract

Description
This evidence-based practice project is a literature review conducted to investigate the impact of bedside nurse education level on patient mortality and failure to rescue (FTR) in the hospital setting.

PICO Question
In inpatient hospital settings, does increasing the ratio of bachelors prepared nurses compared to associates prepared or licensed practical nurses decrease patient mortality and FTR?

Background
This project was conducted in 2015 during my Masters’ of Science in Nursing Program at Seattle Pacific University to become a Clinical Nurse Specialist. My interest in the impact of bedside nurse education level on patient outcomes began during my three-year assignment as a Clinical Nurse Officer in Charge (CNOIC) of a 31-bed medical-oncology unit at Madigan Army Medical Center.

Method and Findings
The literature review revealed the following information.
Aiken, Clarke, Cheung, Sloane, & Silber (2003) A 10% increase in nurses with BSN degrees equals a 5% decrease in the risk of mortality or FTR.
Blegen, Goode, Park, Vaughn, & Spetz (2013) As education level of bedside RNs increased, CHF mortality and FTR significantly decreased.
Estrabrooks, Midodzi, Cummings, Ricker, & Giovannetti (2005) Higher ratios of BSN to ADN and RN to LPN were both associated with lower patient mortality.
Glance, Dick, Osler, Mukamel, Li, & Stone (2012) Every 1% increase in the number of LPNs equaled the odds of patient mortality increasing by 4%.
Kendall-Gallagher, Aiken, Sloane, & Ciomotti (2011) Every 10% increase in BSN nurses equals a 6% decrease in 30-day mortality and failure to rescue.

Implications for Military Nursing
CNOICs should consider skill mix and stratify registered nurses by education level when making staff schedules. CNOICs should also consider education when hiring new staff; even high levels of nurse experience and specialty certifications do not effect patient mortality and FTR as significantly as the number of bachelors prepared bedside nursing staff. The method for increasing bedside nurses’ education level depends on a units’ current skill mix and can be achieved through increasing the ratio of RNs to LPNs or the ratio of BSNs to ADNs.