The percentage of nurses with bachelor's degrees has been increasing in recent years, swelling from 44 percent in 2005 to 57 percent in 2013. But according to a study in the Journal of Nursing Scholarship, the national goal of 80 percent by 2020 probably isn't going to happen.
The projection instead is that about 64 percent of front-line nurses will have bachelor's degrees by then.
The National Academies of Science, Medicine and Engineering set the national benchmark in 2010 when the numbers of nurses with bachelor's degrees was already on the rise.
That the numbers will likely fall short of the goal is problematic. To meet the country's increasing and complex healthcare needs, such as the aging of the baby boomer generation and the expansion of health insurance coverage, nurses are playing a growing role in improving quality of care and patient outcomes.
"A competent nursing workforce is critical," said Chenjuan Ma, an assistant professor at NYU Meyers and the study's author. "One strategy for preparing this workforce is to advance nurse education, particularly by increasing the number of nurses with at least a bachelor's degree."
Growing evidence has demonstrated that more education for nurses is associated with better quality of care and patient outcomes. In fact, studies have shown a link between a higher proportion of hospital nurses with a bachelor's degree in nursing and lower patient mortality rates. That link is what ultimately led to the proposed 80 percent benchmark.
While the growth began several years before the 2010 Institute of Medicine report, the increase accelerated from 2010 on. On average, the proportion of nurses with a bachelor's degree in a unit increased by 1.3 percent annually before 2010 and by 1.9 percent each year from 2010 on. The percentage of units having at least 80 percent of nurses with a bachelor's degree increased from 3 percent in 2009 to 7 percent in 2013.
It will probably take until 2029 to hit the 80 percent goal, and nurses in critical care units are likely to hit the goal first, by 2025, the study said.
"The U.S. nursing workforce is undergoing an educational transformation in order to meet our increasing healthcare needs," said Ma. "To help accelerate this transformation, further advocacy, commitment, and investment are needed from all healthcare stakeholders in order to advance nursing education and in turn improve quality of care and patient outcomes."
Policy changes present one possible means of accelerating nursing education. For instance, policymakers could consider requiring all nurses to obtain bachelor's degrees for professional nursing practice regardless of their initial nursing degree. An example of this can be seen in New York, where NY State Senate Bill S6768 -- also known as BS in 10 -- would require nurses in the state to attain a bachelor's degree in nursing within 10 years of initial licensure.
The researchers suggest that hospital administrators invest in hiring nurses with bachelor's degrees and support those without bachelor's degrees in attaining them, including providing tuition benefits and flexibility in scheduling.