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Hospital Employment of Supplemental Registered Nurses and Patients’ Satisfaction With Care

Lasater, Karen B. MS, RN; Sloane, Douglas M. PhD; Aiken, Linda H. PhD, RN

JONA: The Journal of Nursing Administration: March 2015 - Volume 45 - Issue 3 - p 145–151
doi: 10.1097/NNA.0000000000000174

The aim of this study is to determine whether use of supplemental registered nurses (SRNs) from agencies is associated with patients’ satisfaction.

BACKGROUND: Employment of SRNs is common, but little is known about whether their use is associated with patients’ satisfaction with hospital care.

METHODS: Cross-sectional survey data from nurses in 427 hospitals were linked to American Hospital Association data and patient data from the Hospital Consumer Assessment of Healthcare Providers and Systems survey.

RESULTS: We found little evidence that patients’ satisfaction with care is related to the use of SRNs. After other hospital and nursing characteristics were controlled, greater use of SRNs was not associated with patients’ global satisfaction, including whether they would rank their hospital highly or recommend their hospital, nor was it associated with nurse communication, medication explanation, or pain control.

Conclusions: Employment of SRNs does not detract from patients’ overall satisfaction or satisfaction with nurses specifically.

Author Affiliations: Doctoral Research Fellow (Ms Lasater); Research Professor (Dr Sloane); The Claire M. Fagin Leadership Professor of Nursing, Professor of Sociology, Senior Fellow Leonard Davis Institute for Health Economics (Dr Aiken), Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia.

This research was supported by funding from the National Institute of Nursing Research (R01NR04513 and T32NR0714) and the American Staffing Association Foundation. The organizations providing research funding did not participate in the research or the decision to publish this manuscript. The content of this article is the sole responsibility of the authors.

The authors declare no conflicts of interest.

Correspondence: Dr Aiken, Center for Health Outcomes and Policy Research, School of Nursing, Claire M. Fagin Hall, 418 Curie Blvd, Philadelphia, PA 19104 (

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