A new policy brief from the American Association of Community Colleges (AACC) taps federal data to demonstrate that both associate degree in nursing (ADN) and bachelor’s degree in the science of nursing (BSN) programs contribute to building a strong nursing workforce.

 

The brief, which was funded by Lumina Foundation for Education and the AACC Health Professions Education Center, examines an Institute of Medicine (IOM) report on the future of nursing released last fall using federal data from the 2008 National Sample Survey of Registered Nurses. Supporters of ADN programs have criticized the IOM report for recommending to increase the number of nurses with baccalaureates to 80 percent by 2020 with no data to substantiate the recommendation. In fact, the report notes that “The causal relationship between the academic degree obtained by RNs and patient outcomes is not conclusive in the research literature.” 

 

"The purpose of the brief was to use data to examine the validity of moving 80 percent of the nation’s nursing workforce to the baccalaureate-degree level," said Roxanne Fulcher, director of health professions policy at AACC and co-author of the policy brief. "However, the data demonstrated measure-by-measure that ADN programs surpassed BSN programs in meeting the nation’s workforce and reformed health-system challenges."

 

BSN programs, which are mostly offered at four-year higher education institutions, typically require 120 credit hours; ADN programs—predominately offered at two-year institutions—generally require about 71.5 credit hours. The effectiveness of both program types in preparing RNs for practice is demonstrated through similar pass rates on the national certification licensure exam required of all RNs, according to the AACC brief. 

 

Of the nearly 3.1 million licensed RNs, 45.4 percent were initially educated in ADN programs, compared to 34.2 percent of RNs initially educated in BSN and higher degree programs, according to federal data. Among RNs who graduated in 2005 or later, 56.6 percent received their initial nursing degrees from ADN programs.

 

Community colleges play a crucial role in increasing the nation’s supply of minority nurses, according to AACC. ADN programs educate nearly 55 percent of black RNs, while BSN programs educate 32 percent of RNs from this population. Likewise, ADN programs prepare 55 percent of Hispanic nurses, compared to 39 percent educated in BSN programs.

 

Another benefit of community college nursing programs is the significantly lower cost for students. A student at a public two-year college pays about $6,120 in tuition and fees to earn an RN credential, the brief said. The cost of earning a BSN at a public four-year college is about $28,080.

 

While about the same number of ADN- and BSN-prepared RNs are employed in hospitals or community health settings, more than twice as many ADN-prepared RNs are employed in nursing home or extended-care facilities. This is especially crucial as the number of Americans who live longer and need long-term care increases.

 

RNs educated in community colleges are also an important to the local economy, as most are likely to reside in the state where they were educated, the reports said.

 

“ADN-prepared RNs are a sound economic and social investment to communities, including those in rural America where unique factors create disparities in health care not found in urban America,” the brief said. 

 

ADN programs are also increasingly linking to nursing programs at other colleges and universities to offer pathways to higher degrees. ADN-prepared RNs are poised to become nurse faculty and advanced practice nurses through direct enrollment in the more than 160 RN-to-MSN programs in the U.S. These programs do not require a BSN for students to enroll. 

 

The IOM report recognized the potential of RN-to-MSN programs as a “significant pathway to advanced practice and faculty positions” and the importance of providing financial support to help build capacity of ADN-prepared RNs in those programs, the brief noted.