Objective: The aim of this study was to examine recent trends in nurse staffing levels and nursing staff composition.
Background: Recent trends in hospital nurse staffing have not been well described, and the effects of the 2007 to 2012 recession and 2008 Centers for Medicare & Medicaid Services rule change are unknown.
Methods: A longitudinal study of unit-level data from the National Database of Nursing Quality Indicators® (NDNQI®) and hospital-level data from the American Hospital Association (AHA) annual survey was conducted.
Results: From 2004 to 2011, total nursing hours per patient day on general care units in NDNQI hospitals increased by 11.5%, and registered nurse (RN) hours per patient day by 22.9%. Trends were similar in AHA hospitals.
Conclusions: Hospitals have steadily increased total nurse staffing levels by increasing RN staffing. Use of temporary RNs in hospitals plummeted from mid-2008. There were no apparent changes in staffing levels due to the recession and/or CMS rule change.