Driving Factors Behind the 80% BSN by 2020 Initiative
In 2010, the Institute of Medicine (IOM) issued The Future of Nursing: Leading Change, Advancing Health (Institute of Medicine, 2010a). This report not only informs and highlights the need for change in nursing education to meet the changing face of healthcare but also recommends the nursing profession increase the number of registered nurses (RNs) with a bachelor’s degree in nursing (BSN) to 80 percent by the year 2020 (IOM, 2010a)
Nursing in the 21st century is more complex than ever before (IOM, 2010b). The complexity of this care requires transitioning from skill-based competencies to those that assess knowledge and competence on health policy, system improvement, research, evidence-based practice, teamwork, collaboration, complex decision making, and leadership (IOM, 2010a). The IOM report adds that BSN-prepared nurses are better equipped to manage this increasing complexity in nursing care (IOM, 2010a).
The increasing complexity of care is not the only factor driving the IOM recommendation. The American Association of Colleges of Nursing (AACN) document titled The Impact of Education on Nursing Practice (AACN, 2014) considered the different pre-licensure nursing education through three separate lenses: (1) different approaches to nursing education; (2) recognizing differences among nursing program graduates; and (3) public and private support for BSN-prepared nurses. This was done by providing an overview of several studies which indicate BSN-prepared nurses experience better patient outcomes, and higher competency in nursing practice, as well as increased skills, in communication, leadership, professional integration as well as research and evaluation AACN, 2014.
AACN also emphasizes that hospitals hoping to earn Magnet status must provide proof of plans to increase their BSN workforce to 80% by 2020 and that several large national healthcare organizations already have plans in place to promote and increase their BSN nurses (AACN, 2014). For example, the Veterans Administration (VA) has enacted a policy that requires RNs to have a BSN to be considered for promotion beyond entry-level, and all branches of the United States Armed Forces now require a BSN or higher to practice as an active duty RN (AACN, 2014).
What does all this mean for nurses who have not yet earned a baccalaureate degree? That remains to be seen. Many healthcare facilities have begun requiring RNs to have a BSN for entry-level nursing positions (NursingLicensure.org, 2016). These facilities believe that associate degree nurses (ADN) are well trained to manage day-to-day tasks, but healthcare today requires more than what is taught in ADN programs (NursingLicensure.org, 2016). While the future of the ADN- educated nurse is secure, these nurses may find they have fewer opportunities for professional growth and earn less than their nursing colleagues with baccalaureate degrees.
In light of the increasing complexity of healthcare, the IOM has recommended healthcare organizations increase their BSN nursing staff to 80% by the year 2020. In the report, The Future of Nursing: Leading Change, Advancing Health, the IOM raised concerns regarding the numerous pre-licensure education paths of America’s professional nurses. AACN weighed in, providing several studies which found BSN-prepared RNs experience better patient outcomes, greater nursing competency, more effective communication skills, and stronger leadership skills than their associate degree colleagues. With 2020 just around the corner, some healthcare organizations have begun to change their policies on hiring and promoting nurses based on their nursing degrees.
American Association of Colleges of Nursing (AACN), (2014). Fact sheet: The Impact of Education on Nursing Practice.
Institute of Medicine (IOM), (2010a). The future of nursing, focus on education.
Institute of Medicine (IOM), (2010b). The future of nursing, leading change, advancing health.
NursingLicensure.org, (2016). The future of the associate degree in nursing program.