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March 17, 2004

Relationship Between Patient Mortality and Nurses' Level of Education

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291(11):1320-1323. doi:10.1001/jama.291.11.1321-a

To the Editor: Dr Aiken and colleagues1 concluded that public policy should encourage baccalaureate programs for nurses over associate or hospital diploma programs. Their analysis, however, suggests that nurse staffing has a similar effect on mortality as does education levels: decreasing nursing workloads by 2 patients was predicted to decrease mortality by 1.8 per 1000 patients, the same effect as increasing staff levels of nurses with a bachelor of science in nursing (BSN) degree by 20%. Given an environment of nursing shortages, increasing tuition rates, and an economically diverse labor pool, advocating a one-size-fits-all baccalaureate solution is not cost-effective policy. Increasing the employment of nurses of all types is equally as beneficial as increasing staff levels of those with BSNs. Availability of all types of educational programs allows future nurses to find a program that fits best, leading to a larger nursing labor pool.

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