Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Dec;77(12):4599-4611.
doi: 10.1111/jan.14909. Epub 2021 Jun 3.

The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review

Diane E Twigg  1 , Lisa Whitehead  1 , Gemma Doleman  1   2 , Sonia El-Zaemey  1
Affiliations

The impact of nurse staffing methodologies on nurse and patient outcomes: A systematic review

Diane E Twigg et al. J Adv Nurs. 2021 Dec.

Abstract

Aim: Aim of this study is to systematically review and synthesize available evidence to identify the association between nurse staffing methodologies and nurse and patient outcomes.

Design: Systematic review and narrative synthesis.

Data sources: A search of MEDLINE (EBSCO), CINAHL (EBSCO) and Web of Science was conducted for studies published in English between January 2000 and January 2020.

Review methods: The reporting of this review and narrative synthesis was guided by the preferred reporting items for systematic and meta-analysis guidelines (PRISMA) statement and data synthesis guided by the Synthesis Without Meta-analysis (SWiM) guideline. The quality of each article was assessed using the Mixed Methods Appraisal Tool.

Results: Twenty-two studies met the inclusion criteria. Twenty-one used the mandated minimum nurse-to-patient ratio methodology and one study assessed the number of nurse hours per patient day staffing methodology. Both methodologies were mandated. All studies that reported on nurse outcomes demonstrated an improvement associated with the implementation of mandated minimum nurse-to-patient ratio, but findings related to patient outcomes were inconclusive.

Conclusions: Evidence on the impact of specific nurse staffing methodologies and patient and nurse outcomes remains highly limited. Future studies that examine the impact of specific staffing methodologies on outcomes are required to inform this fundamental area of management and practice.

Keywords: nurse outcomes; nurse staffing; patient outcomes; systematic review; workload methodologies.

PubMed Disclaimer

Conflict of interest statement

No conflict of interest has been declared by the author(s).

Figures

FIGURE 1
FIGURE 1
Search and retrieval process
See this image and copyright information in PMC

References

    1. Aiken, L. H. , Clarke, S. P. , & Sloane, D. M. (2002). Hospital staffing, organization, and quality of care: Cross‐national findings. International Journal for Quality in Health Care, 14(1), 5–14. 10.1093/intqhc/14.1.5 - DOI - PubMed
    1. Aiken, L. H. , Sloane, D. M. , Bruyneel, L. , Van den Heede, K. , Griffiths, P. , Busse, R. , Lesaffre, E. (2014). Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. The Lancet, 383(9931), 1824–1830. - PMC - PubMed
    1. Australian Industrial Relations Commission (2002).
    1. Ball, J. E. , Bruyneel, L. , Aiken, L. H. , Sermeus, W. , Sloane, D. M. , Rafferty, A. M. , … Consortium, R. C. (2018). Post‐operative mortality, missed care and nurse staffing in nine countries: A cross‐sectional study. International Journal of Nursing Studies, 78, 10–15. 10.1016/j.ijnurstu.2017.08.004 - DOI - PMC - PubMed
    1. Bowblis, J. R. , & Ghattas, A. (2017). The impact of minimum quality standard regulations on nursing home staffing, quality, and exit decisions. Review of Industrial Organization, 50(1), 43–68. 10.1007/s11151-016-9528-x - DOI

Publication types