Educational Levels of Hospital Nurses and Surgical Article Critique

Excerpt from Article Critique :

Educational Levels of Hospital Nurses and Surgical Patient Mortality

Whether there is sufficient nursing staff in a hospital has often been thought to have an effect on the well-being of the patients, the quality of care that they receive, and the rate at which they pass away. However, very little is actually known about whether the educational level of the nurses to work at these hospitals has anything to do with the mortality rate of these patients and quality of care that they receive. The basic purpose of this research was to indicate whether the educational level held by a hospital nurse had any reflection upon the mortality rates as surgical patients that they attended.

Specifically, the study examined whether baccalaureate degrees or higher had any reflection upon the ability of hospital offense to rescue and assist surgical patients who were facing serious complications. If these individuals died at the same rate as surgical patients who were attended by nurses with degrees that were higher or they were then baccalaureate level then the education of these nurses would not be found to be significant and saving the lives of surgical patients and would therefore not be a factor.

Another important consideration that he has been believed for many years is that the experience that a nurse has in his or her chosen field is much more important to patient outcome than the educational level that individual possesses. It is now becoming a cause for consideration that more nurses are attending baccalaureate programs and graduating from them. This may have significant effect on patient longevity and outcome in the future, but the effects of this have not yet been studied enough for a determination of this nature to be made.

Problem Statement:

The basic problem statement that relates to this research is whether nurses who have a baccalaureate degree or higher save patients and preserve life at a higher rate than those that do not. The concept is that this may not be related to staffing of nurses in hospitals, which was previously assumed to be the only real indicator of the mortality rate of patients under their care. Nurses who had four or fewer patients seemed to show a mortality rate for their patients that was less than nurses that had eight or more patients under their care. While this staffing information is likely still very important, it does not look at the whole picture. Therefore, other studies must be done to indicate whether there are more significant factors other than the ratio of nurses to patients. It is likely that the educational level of these nurses also affects the mortality rate of the patients that they care for in any given shift, but the previous studies into this concern have always been inconclusive.

Human Subjects Approval:

Since there is no experimental issue involved with this particular study, there is no need to have a human subjects approval. It is not necessary because the only way that the data was collected was through the use of surveys that were mailed to the homes of individual nurses. Surveys are answered in a totally voluntary manner and there was no risk or reward offered to any of the individuals that chose to either participate or not participate in the study by means of filling out a survey and mailing it back.

Research Questions and Hypothesis:

The main research question was whether the educational level of nurses was related to the mortality rate of surgical patients in their care, and whether this was significant regardless of the amount of staffing that the hospital had and how many patients each nurse had to take care of. The hypothesis was that the education of a nurse would make a difference because they have more problem solving skills and other abilities that can only come from more time in the classroom and their knowledge and understanding of how various things work.

While clinical experience and know-how is extremely important, there is also a learned component that only comes from the coursework and an understanding of it. It is believed that this particular bit of knowledge will make these nurses more suitable to helping patients and therefore reduce the mortality rate of surgical patients. This is especially true of those that have complications, as nurses who have been through a four-year program and have received baccalaureate degrees are presumed more likely to be able to perform more complex procedures and do more things at one time while still focusing on the task at hand. Because they are able to function on this level, it is believed that they have more experience and more education in the field. They will theoretically be able to do more for any given patient than a nurse who still lacks some of the fundamental knowledge that he or she would have learned in a four-year baccalaureate program.

Research Design:

For this particular study of the authors revisited 168 hospitals in Pennsylvania that they have used in a previous study. The previous study looked at patient to nurse ratios at these hospitals and whether the amount of nurses on duty related to the mortality rate of patients who had serious complications. Because there were many variations in how many nurses in each hospital held a baccalaureate degree or higher the hospitals in question provided a good opportunity to conduct the study discussed here and examined whether there is an association between the education found in a hospitals nursing staff and the mortality rate of surgical patients. They sent out surveys to nurses in the area and got a great deal of responses. The response rate of over 50% was also in line with other surveys that have been taken of health-care professionals, and therefore was likely to be an accurate representation of what the researchers were desirous of finding out.


In the course of the study the researchers found that many hospitals had disproportionate numbers of nurses who had a baccalaureate degree or higher. Some hospitals had no nurses with this qualification while others had more than 75% of their nurses meeting this qualification. There were adjustments made for specific patient characteristics and also for the size and other characteristics of any given hospital. After these, as well as information about the surgeon, had been adjusted for it was found that there was a 5% decrease in the mortality rate of patients within 30 days of admission for every 10% increase in the amount of nurses who had a baccalaureate degree or higher. This was also true of the mortality rates of failure-to-rescue individuals. This was found to be very significant because it became a clear indicator that there was more than just the amount of nurses on staff that affect how long patients live and how well they do in the hospital after surgery. This is important for patients to be aware of when they go to a hospital, and it is also important for the future of nursing as well as research.


Conclusions found in the study indicated that the hypothesis created earlier was relatively accurate. In the hospitals that carried a higher amount of nurses who had at least a baccalaureate degree, there were lower rates of mortality and failure-to-rescue for surgical patients. This would indicate that education does indeed play a role in how well a nurse can perform his or her job and that the amount of nurses on staff, while still likely significant, is not the only marker of how well patients are treated in a hospital.


The recommendations include making sure that the percentage of nurses that have baccalaureate decrees or higher is as high in each hospital as it possibly can be. Another recommendation would be that those that are teaching nurses…

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