Nurses with a degree in nursing provide better care than nurses who do not have a degree, according to our latest research. If you live in the UK, this should be reassuring news. To work as a nurse in the UK, you need a degree in nursing.
We conducted our study in Qatar because the hospitals keep excellent electronic records. Our sample comprised 5,000 nurses and over 7,000 patients from seven hospitals. Most of the nurses were foreigners (largely from the Philippines). Around half the nurses had a degree.
Patients admitted to any ward in the hospitals for at least one day, for any reason, were included in the study. Around 200 patients died during the study period.
Having analysed the data, we found that the more a patient was cared for by a nurse with a degree, the more likely they were to leave hospital alive.
Confirming Earlier Studies
This is not the first study to show that graduate nurses are better at caring for patients. Early studies from the US showed that “failure to rescue” (a euphemism for “death”) after an operation is lower in hospitals where there is a higher proportion of nurses with degrees.
More recent work in Europe, involving nine countries and looking at over 400,000 patients, also showed that patients were less likely to die in hospitals where there was a higher proportion of nurses with degrees. But our research is unique as it is the first time the information about the actual nurse who cared for a specific patient has been linked to the outcome. The other studies from the US and Europe had not made this link – having only dealt in aggregates – and for that reason cannot say for sure that there was not some other explanation for their results.
In common with these other studies, our research also shows that when nurses had fewer patients to care for, the patients were more likely to survive their stay in hospital.
We were careful to rule out other factors that might explain the better rates of patient survival. Patients who were more critically ill or who had been in hospital longer may be less likely to live, and nurses who had been in the job for longer may provide better care, too. But these things had no effect on the fact that patients who were cared for more often by graduates were more likely to live.
The Optimum Level
Of course, it is not possible, due to cost and availability constraints, for every hospital to have a full complement of degree-educated nurses, so we estimated the optimum level. It turns out that if 70% of the care a patient receives is provided by nurses with degrees then that is as good as it gets. If the percentage of nurses with degrees is increased above 70% then patients are no more likely to survive their stay in hospital. So, all nurses do not have to have degrees, but most of them do.
The fact that patients cared for by nurses with degrees are more likely to survive is good news for universities who educate nurses. It also supports the present UK government policy that all nurses in the UK should leave university with a degree.
Roger Watson is a graduate of The University of Edinburgh with a PhD in biochemistry from The University of Sheffield who qualified in nursing at St George’s Hospital, London. Working in care of older people, he has a special interest in the feeding and nutritional problems of older people with dementia. He is Editor-in-Chief of Journal of Advanced Nursing and Editor of Nursing Open. A frequent visitor to the Far East, South East Asia and Australia, he has honorary and visiting positions in China, Hong Kong, and Australia. He is Professor of Nursing, University of Hull, UK and was a member of the UK 2014 Research Excellence Framework sub-panel for Allied Health Professions, Dentistry, Nursing and Pharmacy.