Barbara Zittel, RN, Ph.D.

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BSN in 10-What Every Nurse Needs to Know 
Barbara Zittel, RN, Ph.D.
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Trends in Nursing Education
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Each year, out of 100 RNs seekingNYS licensure,
62 are Associate and 38 are Baccalaureate
Graduates

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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)
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RESEARCH FINDINGS Multiple Researchers have
demonstrated a significant relationship between
nursing education and improved patient outcomes
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As Nurse Education Increases,
Patient Mortality Decreases.
Deaths per 1000 patients with complications
Aiken, 2003, JAMA
90 deaths in 1,000 patients
84 deaths in 1,000 patients
76 deaths in 1,000 patients

Education (Percentage of
hospital nurses with BS degrees.)
232,342 patients from 168 PA
non-federal adult general hospitals.
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NYS Thirty Day Surgical Mortality Preventable
with each 10 Increase in BS Prepared Nurses
NYS 30 day mortality surgical discharges
Percentage of Decreased Deaths
with each 10 increase in BS Prepared Nurses
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Replication of Aiken study in 18,142
patients in 49 hospitals in Alberta, Canada
with identical results
Estabrooks, et al. (2005)

• Hospitals with a higher proportion of BSN
  RNs experienced lower rates of 30-day patient
  mortality

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Tourangeau (2007)

• Study of 46, 993 patients
• Demonstrated 9 fewer deaths per 1,000 discharges
  for every 10 increase in BS prepared nurses

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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

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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.
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Transformation of Nursing Education
Canada New RNs must be BS prepared
European Union BS required
Philippines BSN Required Since 1988
Turkey BSN required since 1997
Thailand BS required
Australia BSN Required Since 1992
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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. Lic. Mental Hlth
Couns.
Physical Therapist Medicine Dentistry Podiatry Psy
chology Pharmacy
Athletic Training
RN
Diploma/Associate
Masters
Doctorate
BS
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2010 Carnegie Foundation report Educating Nurses
A Call for Radical Transformation (Patricia
Benner, et al.) calls for the BS degree in
nursing for licensure
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2008-RWJF-IOM Collaboration
Chaired by former Department of Health and Human
Services Secretary Donna Shalala
2010- Release of the Report
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October 2010 Report Recommends that 80 of RNs
be prepared with the BS degree by 2020.
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• 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.
• True
• False

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• 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.
• True
• False

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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.

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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
         Opportunity for an extension
beyond 10 years, for extenuating circumstances,
as determined by the Department.
Provisions that would place a Registered Nurses
license on hold if the baccalaureate degree is
not obtained in 10 years.
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Current Status of the Boards Motion


NYONE takes Lead in Seeking Legislative Support
Assembly Bill ?? Sponsor?? Senate Bill ??
Sponsor??
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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.
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The Plight of New Graduates
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Many hospitals are responding to research and
Magnet expectations by requiring their nursing
staff to hold the BS in Nursing degree.
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Perceived Problems/Concerns
STATEMENT RESPONSE
If I get my BS I will be removed from bedside nursing.
Im content at what Im doing why should I go on to the BS degree?
Im just as good as any BS prepared nurse!


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