Education Levels for Nurses Correlates to Patient Mortality, Study Says

Pediatric ICU nurses with more experience and education cut inpatient mortality.

A multi-institution study from 38 children’s hospitals, led by Patricia Hickey, vice president of critical care and cardiovascular services at Boston Children’s Hospital, showed that nursing education and experience significantly impacts the outcome for patients undergoing cardiac surgery. To decrease mortality rates, researchers recommend that there be no more than 20 percent of nurses with less than two years of clinical experience in pediatric ICUs.

According to Boston Children’s Hospital, when it comes to pediatrics, congenital heart disease is the most commonly occurring birth defect that requires surgery. The study, which will be published in the December 2013 issue of the Journal of Nursing Administration, looked at 20,407 pediatric cardiac surgery patients. Improved patient outcomes was directly associated with the number of years a nurse had under his or her “belt” in the field. When more than 25 percent of nurses have two years of experience or less, the odds of in-hospital mortality increases.

“Ongoing attention to the proportional mix of RN experience levels in pediatric units is necessary,” Hickey says. “There is a continued need for retention strategies to ensure that experienced nurses remain in the pediatric critical care environment. Our findings support the IOM recommendations for nurse residency programs to support new graduate nurses.”

The number of years of ICU experience alone was not a predictor of mortality, but the total clinical experience was a major factor. The study’s authors also found that experiential knowledge and skill acquisition is cumulative over time regardless of the clinical setting.

“While prior studies have associated greater proportions of nurses educated at the baccalaureate level or higher with lower mortality and failure-to-rescue rates, Dr. Hickey and colleagues have specifically advanced the science of pediatric nursing practice to affirm the importance of RN experience levels and educational preparation in the safe and effective care of children. This work will inform our ongoing efforts to improve care for our patients,” says Laura Wood, senior vice president and chief nursing officer at Boston Children’s.