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The Associate Degree in Nursing (ADN)
For facts about the associate degree in nursing, the leading educational pathway chosen by prospective RNs, access the 2011 AACC Allied Health & Nursing Brochure (PDF).

A Data-Driven Examination of the Impact of Associate and Bachelor's Degree Programs on the Nation's Nursing Workforce
An AACC research brief (March 2011) providing: discussion of recommendation for a 2020 nursing workforce in which 80 percent of RNs hold a bachelor's degree; detailed analysis of federal nursing workforce data.

RN to MSN (Master's in the Science of Nursing) Programs: An Accelerated Pathway
Hundreds of nursing programs offer ADN-prepared RNs direct enrollment in graduate-level nursing (MSN) programs. These programs provide RNs with the competencies necessary for career progression beyond the scope of practice authorized by the RN license as well as with additional earning potential. See a listing of RN to MSN Programs.

Magnet Recognition Program
The Magnet designation is a hospital credentialing program administered by the American Nurses Credentialing Center (ANCC), which claims that it is the "credential of organizational recognition of nursing excellence." The HPEC Newsletter (September 2011) describes the Magnet program and how ADN education programs incorporate key Magnet concepts pertinent to the practice of DCNs in a Magnet organization.

Research and Studies

Kutney-Lee, Sloane and Aiken (2013), An Increase In The Number Of Nurses With Baccalaureate Degrees Is Linked To Lower Rates Of Postsurgery Mortality (PDF), Health Affairs.
An update of Aiken’s 2003 study, the authors present questionable analysis and assumptions that the single variable of RN educational preparation can impact patient outcomes in today’s complex health care environment. 

April 2, 2013 -- In AACC's response, Getting to Better Health Care Defies Simple Solution (PDF), HPEC director Roxanne Fulcher questions the study’s assumption that the BSN is a singular solution to improving patient care.

State by State Nursing Exam Data
Access the most recent compilations of statistics on NCLEX pass rates by state and degree type in 2010 Nurse Licensee Volume and NCLEX Examination Statistics (NCSBN, 2012, pp. Sec3:29-30), including a comparison of pass rates by degree type (PDF). The quarterly and annual pass rates were revised by the National Council of State Boards of Nursing in April 2012, with 2011 pass rates by state to be released Spring 2013. The timeframe for which state-level data is available varies state-by-state; contact your state board of nursing for more recent data.

RNs Employed in Nursing by State/Region and Highest Degree
NSSRN data demonstrating the percentage of BSNs needed to achieve an 80% BSN workforce by 2020 (PDF), noting state recipients of RWJF grants to secure employment for BSN graduates and achieve 80/20.

RNs by Age and Region
NSSRN data demonstrating projected RN turnover and imminent nursing shortage (PDF), indicating prospective jobs for ADN graduates.

RN Data Sources: An AACC Summary
AACC provides a summary of a December 2012 webinar in which a panel of researchers, convened by Robert Wood Johnson Foundation/AARP’s Center to Champion Nursing in America, identified data sources for analyzing nurse workforce supply, demand and projections, as well as RN education and demographics; the panel says these data sources sufficiently replace the NSSRN, which has been discontinued.

The Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine:
The Future of Nursing: Leading Change, Advancing Health

The Commission's report released in January 2010, makes the point: "The causal relationship between the academic degree obtained by RNs and patient outcomes is not conclusive in the research literature." Notwithstanding this acknowledgement, the report makes the recommendation, "to increase the proportion of nurses with a baccalaureate degree to 80 percent by 2020."

February 22, 2010 -- AACC offered written testimony in support of associate degree in nursing programs and graduates, What, How, and Where We Should Teach (PDF) at the Robert Wood Johnson Foundation Future of Nursing Initiative at the Institute of Medicine (IOM) Forum on Education.

March 22, 2011 -- For a better understanding of the evidence behind the Institute of Medicine recommendation about RN education and what most current federal data demonstrate associate degree nursing programs contribute to the nation's nursing workforce,  see AACC's policy brief: A Data-Driven Examination of the Impact of Associate and Bachelor’s Degree Programs on the Nation's Nursing Workforce (PDF).

The Carnegie Foundation for the Advancement of Teaching: Educating Nurses: A Call for Radical Transformation
In this report released in January 2010, the Carnegie Foundation recommends that all entry-level RNs complete a baccalaureate degree in nursing and within ten years obtain a master's degree.

January 8, 2010 -- AACC's response to the Carnegie report (PDF) discusses the consequences of denying access to the RN profession through associate degree in nursing programs that provide the most cost-effective and efficient pathway to the nursing workforce as well as deliver America the majority of RNs and the greatest nursing workforce diversity.

January 8, 2010 -- AACC's affiliated council, the National Organization for Associate Degree Nursing, issued a statement (PDF) that asserts that a bachelor's degree in nursing should not be required for continued practice beyond initial licensure as an RN, and that it should be choice, not mandate, to pursue education beyond the associate degree in nursing (ADN) based on an ADN's personal preferences and professional career goals.

January 8, 2010 -- Inside Higher Ed publishes the article Nursing Tug of War in which ADN proponents take issue with the Carnegie report for its lack of evidence-based recommendations that would impose continuing education as a mandatory requirement and require all nurses to have baccalaureate degrees; both recommendations, they say, "would cripple the nation's supply of nurses."

  • January 12, 2010 -- Comment posted by AACC's director of the Health Professions Education Center regarding the Inside Higher Ed article.

National Sample Survey of Registered Nurses (NSSRN)
The NSSRN is a gauge of the capacity of the nursing workforce to provide essential health care services, compiling information on education, skills, diversity and factors related to the future supply of RNs. The survey reports include comparisons with past surveys, statistics and trends on the nation's largest health profession.

September 22, 2010 -- U.S. Department of Health and Human Services releases this survey every four years, the most recent being the NSSRN (2008).

Urban Institute (2009), Understanding the Nursing Workforce: Public Policy for a Dynamic and Complex Market
Many rural and underserved communities rely on community colleges for their nursing workforce:  the Urban Institute suggests in its report that, “medical personnel, including nurses, tend to work near where they were trained, so the distribution of support for nursing education matters” and, furthermore, “that simply producing more nurses may not be effective in alleviating areas’ shortages if attention is not paid to where the nurses are produced.”

Dr. Anne Sales et al. (2008), The Association Between Nursing Factors and Patient Mortality in the Veterans Health Administration, Medical Care
Researchers for the Veterans Administration, led by Dr. Anne Sales, issue a retrospective observational study using administrative data from 129,579 patients from 453 nursing units (171 ICU and 282 non-ICU) in 123 VHA hospitals.

September 2008 -- Veterans Administration researchers publish the study's results, refuting those of the controversial Aiken study (cited below) by finding RN education was not significantly associated with patient mortality.

Dr. Linda Aiken et al. (2003), Educational Levels of Hospital Nurses and Surgical Patient Mortality, Journal of the American Medical Association
This study purports to demonstrate that hospitals with more baccalaureate nurses have better patient mortality outcomes after surgery. On its face, this study is a disservice to the hundreds of thousands of ADN-prepared nurses across the country - which take and pass, at comparable or higher rates, the same licensing exams that all nurses must take.

September 25, 2003 -- AACC issues a press release, Deceptive Study Maligns Millions of Nurses, which focuses on the manner in which the Aiken study erroneously links increased mortality among surgical patients in the state of Pennsylvania to the educational level of RNs. AACC's internal researchers discern numerous methodological flaws in the study and its findings.

October 3, 2003 -- AACC issues a Media Action Alert (PDF) with talking points that refute the Aiken study and support community college nursing education, along with general information about how and when to interact with the news media.

October 15, 2003 -- AACC refutes the Aiken study by issuing a research analysis and sample op-ed and letter to the editor titled, Associate Degree Nurses Vital to the Nation's Health: Flawed Study Unduly Alarms Public.

AACC (2003), Results of AACC Nursing and Allied Health Initiative Survey (PDF)
According to 420 associate degree nursing programs that responded to this AACC nursing and allied health initiative (NAHI) Survey, nursing school enrollments are stunted due to a lack of qualified faculty, clinical, classroom, and lab space, and preceptors.  Survey respondents reported a 16 percent increase in the number of new students admitted to ADN programs between 2001 and 2002 with increases seen in all regions and rural/urban settings.


 Contact Information

For more information, please contact:

Roxanne Fulcher
Director, Health Professions Policy
Ph: 202.728.0200 x274

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