The Impact of Nurse Staffing on Hospital Quality

Research briefs from the Robert Wood Johnson Foundation (RWJF) Nursing Research Network identify specific ways nurses affect patient care quality and outcomes. Since 2005, the Interdisciplinary Nursing Quality Research Initiative (INQRI) program has supported interdisciplinary teams that involved nursing scholars and scholars from other disciplines in research projects—from the conceptual study design to the adoption in practice of new measures of standards of care.

This research brief estimates the impact of nurse staffing on hospital performance improvement in the Centers for Medicare and Medicaid (CMS)/Premier Hospital Quality Incentive Demonstration (HQID) project.

Key Findings

  • Increased registered nurse (RN) hours per patient day were associated with higher quality.

  • Across models, there were no consistent patterns related to the impact of licensed practical nurse (LPN) and nursing assistant (NA) hours on quality.

  • The results suggest that RNs affect the care processes that are related to quality outcomes. The research team also acknowledges that many other factors also affect these care processes but that available data did not allow for identification of those factors.

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To support interdisciplinary studies that address critical knowledge gaps regarding causal linkages between nursing and health care quality and to synthesize, translate, and disseminate major findings to key stakeholders.

More from Interdisciplinary Nursing Quality Research Initiative