This study examines the relationship between the educational composition of registered nurses (RNs) in hospitals and patient outcomes, specifically risk-adjusted mortality and failure to rescue among surgical patients. The researchers analyzed data from 168 nonfederal adult general hospitals in Pennsylvania, covering 232-342 general, orthopedic, and vascular surgery patients discharged between April 1, 1998, and November 30, 1999. The study found that a 10% increase in the proportion of nurses with a bachelor's degree or higher was associated with a 5% decrease in both 30-day mortality and failure to rescue rates. Hospitals with higher proportions of baccalaureate-prepared nurses tended to be larger, have postgraduate medical training programs, and high-technology facilities, but also had slightly less experienced nurses and lower mean workloads. The findings suggest that increasing the proportion of highly educated nurses in hospitals can significantly improve patient outcomes, particularly for surgical patients and those experiencing serious complications.This study examines the relationship between the educational composition of registered nurses (RNs) in hospitals and patient outcomes, specifically risk-adjusted mortality and failure to rescue among surgical patients. The researchers analyzed data from 168 nonfederal adult general hospitals in Pennsylvania, covering 232-342 general, orthopedic, and vascular surgery patients discharged between April 1, 1998, and November 30, 1999. The study found that a 10% increase in the proportion of nurses with a bachelor's degree or higher was associated with a 5% decrease in both 30-day mortality and failure to rescue rates. Hospitals with higher proportions of baccalaureate-prepared nurses tended to be larger, have postgraduate medical training programs, and high-technology facilities, but also had slightly less experienced nurses and lower mean workloads. The findings suggest that increasing the proportion of highly educated nurses in hospitals can significantly improve patient outcomes, particularly for surgical patients and those experiencing serious complications.