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

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.

EXHIBIT 3. Predicted probability of patient survival with good cerebral performance following in-hospital cardiac arrest, by hospital percentage of nurses with a bachelor of science in nursing (BSN)

SOURCE Authors’ analysis of data for 2013–18 from the Get With the Guidelines–Resuscitation registry. NOTES The vertical axis shows predicted probability of patient survival with good cerebral performance following in-hospital cardiac arrest. Predicted probabilities were adjusted for the patient and hospital characteristics listed in the notes to exhibit 2. Good cerebral performance is defined in the text. The error bars indicate 95% confidence intervals.