Policy Implications of Research on Nurse Staffing and Quality of Patient Care

This article provides a comprehensive overview of nursing workforce studies, examines current efforts to investigate the relationship between hospital nurse staffing and patient outcomes that are sensitive to nursing, and discusses the implications for public and private policy making. Although the impact of hospital restructuring on nurses is generally well known, public policy making in this area has not resulted in significant changes. The lack of substantial policy is attributed to insufficient empirical evidence linking changes in hospital nurse staffing to adverse patient outcomes. Even though new studies are providing a rapidly expanding body of knowledge, readers are urged to use caution when using these findings to support mandated hospital nurse staffing levels. The level of sophistication that would allow precise estimates of minimal acceptable staffing levels and ratios will not be achieved. The authors suggest areas for future research that would further knowledge and policy development in this area.