80% BSNs by 2020: How 3 Hospitals Approach the Goal

Three years ago this month, the Institute of Medicine released a report titled "Future of Nursing: Leading Change, Advancing Health," giving the industry a blueprint to transform nursing and, therefore, improve healthcare. One of the report's recommendations was to increase the proportion of nurses with baccalaureate degrees to 80 percent by 2020. In 2010, 50 percent of nurses had a bachelor's degree, according to the report.

Now, the Robert Wood Johnson Foundation's Human Capital Blog has gathered insight from healthcare leaders across the nation on how nursing has advanced over the last three years. The 80 percent recommendation has caused some hospitals to change how they hire nurses and better support those who want to continue their education.

For example, Virginia Mason Medical Center in Seattle instituted a BSN-only hiring guideline in 2012 after the release of the IOM report, according to a blog post by Charleen Tachibana, MN, RN, senior vice president, hospital administrator and CNO at the hospital.

"The publication of the IOM report on the Future of Nursing really provided the momentum to move to another level," she wrote. "The prominence of this report has made this a relatively easy transition and provided the clarity on why this is critical for our patients and for our profession at this point in time."

With the hiring guideline in place, along with tuition reimbursement and pay differentials for workers with higher education levels, the rate of nurses with a bachelor's degree or higher have topped 70 percent at Virginia Mason. The hospital is on track to meet the 80 percent mark by 2015.

Texas Health Presbyterian Hospital Dallas changed its whole 2011 strategic plan for nursing in light of the IOM report and the 80 percent recommendation.

"We secured a partnership with an RN to BSN program, prioritized tuition reimbursement…launched an image campaign with compelling reasons to obtain a BSN, shifted recruitment to focus more on BSN schools and initiated a preferential hiring practice to hire more BSN-prepared nurses," the hospital's CNO, Cole Edmonson, RN, explained in a blog post.

Now in 2013, Texas Health Presbyterian increased the percent of BSN-prepared nurses at the bedside by 16 percent, to a total of 67 percent of all hospital nurses. Additionally, more than 150 nurses are in the RN to BSN program and will graduate in the next two years, according to the blog post.

On the other side of the spectrum, the number of nurses with BSNs at University Hospital and the Richard M. Ross Heart Hospital of the Ohio State University Wexner Medical Center in Columbus has dropped.

"We are committed to the goal of hiring RNs with a minimum BSN. It is part of our Magnet journey," Jerry A. Mansfield, PhD, RN, CNO of the two hospitals, wrote in the blog. The hospital is seeking its second Magnet re-designation. "Yet…we found ourselves with a greater demand for nurses than supply."

So, to meet demand, the hospitals looked to hire qualified RNs committed to continuing education, according to Dr. Mansfield. While the number of nurses with BSNs as fallen, there has still been an increase in the number of nurses enrolled in an RN to BSN program, Dr. Mansfield noted.

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