Summary Impact of Nurse Staffing On Cost and Length of Stay
Analysis of the findings from the included studies are presented in Tables 3 and 4. Table 3 presents summary data of the impact of nurse staffing on hospital costs and Table 4 presents summary data of the impact of nurse staffing on patient length of stay.
Impact of nurse staffing on hospital costs. Results of studies that estimated the relationship between nurse staffing and cost were mixed. Ten studies reported an association between nurse staffing and costs while two studies reported no statistical significance. As seen in Table 3, three studies reported that higher registered nurse-to-patient ratios reduced hospital costs. One study encouraged reducing costs by increasing the number of experienced RNs (Bloom et al., 1997). The review of recent studies suggests that the proportion of RNs to other nursing staff (or skill mix) is inversely related to costs. However, no significant relationship between skill mix and costs was reported in two studies when the researchers estimated costs by using total hospital expenditure. Two studies encouraged reducing costs by increasing RN hours. Nevertheless, conflicting results were found as studies used total hospital expenditures and the nursing personnel budget as indicators of costs. Impact of nurse staffing on patient length of stay. The effect of nurse staffing on patient length of stay was examined in 11 studies. Eight studies showed that the level of RN staffing was related to LOS while three studies did not. In Table 4, 10 studies showed that the registered nurse- to-patient ratios, hours per patient day and skill mix were significantly related to patient LOS. Interestingly, no studies evaluated the effect of RN staff experience and RN staff education on LOS.