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OBJECTIVES:The aim of this study was to examine the effects of registered nurse (RN) education by determining whether nurse-sensitive patient outcomes were better in hospitals with a higher proportion of RNs with baccalaureate degrees. BACKGROUND:The Future of Nursing report recommends increasing the percentage of RNs with baccalaureate degrees from 50% to 80% by 2020. Research has linked RN education levels to hospital mortality rates but not with other nurse-sensitive outcomes. METHODS:This was a cross-sectional study that, with the use of data from 21 University HealthSystem Consortium hospitals, analyzed the association between RN education and patient outcomes (risk-adjusted patient safety and quality of care indicators), controlling for nurse staffing and hospital characteristics. RESULTS:Hospitals with a higher percentage of RNs with baccalaureate or higher degrees had lower congestive heart failure mortality, decubitus ulcers, failure to rescue, and postoperative deep vein thrombosis or pulmonary embolism and shorter length of stay. CONCLUSION:The recommendation of the Future of Nursing report to increase RN education levels is supported by these findings.

Background: Nurse staffing has been linked to hospital patient outcomes; however, previous results were inconsistent because of variations in measures of staffing and were only rarely specific to types of patient care units. Objective: To determine the relationship between nurse staffing in general and intensive care units and patient outcomes and determine whether safety net status affects this relationship. Research Design: A cross-sectional design used data from hospitals belonging to the University HealthSystem Consortium. Subjects: Data were available for approximately 1.1 million adult patient discharges and staffing for 872 patient care units from 54 hospitals. Measures: Total hours of nursing care [Registered Nurses (RNs), Licensed Practical Nurses, and assistants] determined per inpatient day (TotHPD) and RN skill mix were the measures of staffing; Agency for Healthcare Research and Quality risk-adjusted safety and quality indicators were the outcome measures. Results: TotHPD in general units was associated with lower rates of congestive heart failure mortality (P<0.05), failure to rescue infections (P<0.01), and prolonged length of stay (P<0.01). RN skill mix in general units was associated with reduced failure to rescue (P<0.01) and infections (P<0.05). TotHPD in intensive care units was associated with fewer infections (P<0.05) and decubitus ulcers (P<0.10). RN skill mix was associated with fewer cases of sepsis (P<0.01) and failure to rescue (P<0.05). Safety-net status was associated with higher rates of congestive heart failure mortality, decubitus ulcers, and failure to rescue. Conclusions: Higher nurse staffing protected patients from poor outcomes; however, hospital safety-net status introduced complexities in this relationship.

Nurse residency programs have been developed with the goal of helping newly licensed nurses successfully transition to independent practice. The authors propose that all newly licensed nurses hired in acute care hospitals be required to complete an accredited residency program. An evidence table examines the state of the science related to transition-to-practice programs and provides the basis for recommendations.

OBJECTIVES:The aim of this study was to examine outcomes from 10 years of research on a post-baccalaureate new graduate nurse residency program and to report lessons learned. BACKGROUND:Transition to practice programs are recommended by the Future of Nursing report, the Carnegie Foundation study, the Joint Commission, and the National Council of State Boards of Nursing. METHODS:Data from new graduate residents who participated in the University HealthSystem Consortium/American Association of Colleges of Nursing residency from 2002 through 2012 are presented. Analysis of variance results from the Casey-Fink Graduate Nurse Experience Scale and outcomes from the graduate nurse program evaluation instrument are provided. RESULTS:Retention rates for new graduates in the residency increased considerably in the participating hospitals. Residents’ perception of their ability to organize and prioritize their work, communicate, and provide clinical leadership showed statistically significant increases over the 1-year program. CONCLUSION:The recommendations for new graduate nurse residency programs are supported by the findings.

Some nurse executives and academic nurse leaders believe that the issue of educational entry into professional nursing practice is an “old” issue. Nursing is the only healthcare profession that still does not require the minimum of a baccalaureate degree (BSN). It is time for nurse leaders to acteliminate the multiple educational levels and require a minimum BSN degree for professional nurse practice.

Objective: This study compared patient outcomes and staffing in Magnet® and non-Magnet hospitals. Background: The pursuit of Magnet designation is a highly regarded program for improving staff and patient outcomes. Research has confirmed that Magnet hospitals provide positive work environments for nurses. Research related to patient outcomes in Magnet hospitals is scarce, and results vary. Methods: The University Health Systems Consortium provided the clinical and operational databases for the study. Using bivariate and multivariate analyses, a comparison of patient outcomes and nurse staffing in general units and ICUs of Magnet and non-Magnet hospitals was studied. Outcomes: Non-Magnet hospitals had better patient outcomes than Magnet hospitals. Magnet hospitals had slightly better outcomes for pressure ulcers, but infections, postoperative sepsis, and postoperative metabolic derangement outcomes were worse in Magnet hospitals. Magnet hospitals also had lower staffing numbers. Conclusions: Magnet hospitals in this study had less total staff and a lower RN skill mix compared with non-Magnet hospitals, which contributed to the outcomes.

The number of new graduates who will be needed to fill positions in our acute-care hospitals is astounding. The hiring and precepting of this many inexperienced nurses will severely tax hospital resources. A sound plan must be developed to maintain quality of care and patient safety with the influx of so many new nurse graduates. New graduates also must have a positive learning experience in order to keep them in the nursing workforce. A residency program is essential for new graduates. The Centers for Medicare and Medicaid Services must step to the plate and support accredited nurse residency programs with pass-through dollars.

The authors document the 1-year outcomes of the postbaccalaureate residency program jointly developed and implemented by the University Health-System Consortium and the American Association of Colleges of Nursing. Data on 2 cohorts of residents (n = 679) in 12 sites across the country are presented. The 1-year termination rate was 12%, after those lost to the program because of National Council Licensure Examination failure, serious illness, or death were eliminated from the analysis. Additional analyses using data collected at entry to the program, 6 months, and 1 year using 3 instruments, the Casey-Fink Graduate Nurse Experience Survey, the Gerber's Control Over Nursing Practice Scale, and the McCloskey Mueller Satisfaction Scale, are presented and discussed.

This manuscript describes a collaborative, seamless program between a community college and a university college of nursing designed to increase the number of nurses prepared with a baccalaureate degree. The three-year Integrated Nursing Pathway provides community college students with a non-nursing associate degree, early introduction to nursing, and seamless progression through BSN education. The model includes dual admission and advising and is driven by the need for collaboration with community colleges, the need to increase the percentage of racial-ethnic minority students, the shortage of faculty, and employer preferences for BSN graduates.

OBJECTIVE:The aim of this study was to map an academic hospital’s nursing contributions to the literature using bibliometric methods. BACKGROUND:Nurse executives continue to search for ways to share knowledge gained in the clinical setting. Manuscripts from clinical nurses must increase to advance the science of nursing practice and nursing administration. METHODS:A search of electronic databases and curriculum vitae provided bibliographic data for University of Colorado Hospital (UCH) nurses from 1990 to 2012. Bibliometric techniques were used for publication counts and citation analysis. A review of the infrastructure supporting scholarly work was undertaken. RESULTS:A total of 191 journal articles, 9 books, 103 book chapters, 5 manuals, and 46 manual chapters were published by UCH nurses. Author productivity steadily increased. Citation analysis indicated that the works published were used by others. The h-index for UCH authors was 25. The hospital culture, interdisciplinary practice, and the role of the research nurse scientists had an impact on study results.