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March 17, 2004

Relationship Between Patient Mortality and Nurses' Level of Education

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

To the Editor: Dr Aiken and colleagues1 studied hospitals, not the educational level of individual RNs or the care delivered by individual nurses. Several nurses may care for a patient during a hospital stay. Because of staffing variability, it is impossible to correlate patient outcomes with any particular nurse(s) in this study. In a hospital categorized as having a high proportion of baccalaureate-prepared nurses, it could well have been the RN with an associate degree who took care of the patients who survived or who were rescued. Another important consideration is that hospitals with low numbers of baccalaureate-prepared nurses were smaller, rural facilities with fewer financial, educational, and technological resources than hospitals with larger numbers of baccalaureate-prepared nurses. These are important variables that undoubtedly affect patient care and outcomes.

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