Research Objective: Nurses report a decline in RN/patient and skill mix in the 1990s. This paper examines hospital nurse staffing in Pennsylvania from 1991-1997.
Study Design: Data are from the Pennsylvania Department of Health, the American Hospital Association, and the Pennsylvania Health Care Cost Containment Council. Staffing variables include yearly numbers of RNs, LPNs, nurse assistants, licensed personnel (RNs +LPNs), and total nursing personnel (RNs, + LPNs, + nursing assistants) in acute-care Pennsylvania hospitals. Patient variables include adjusted patient days of care (APDC), additionally adjusted for acuity. Aggregate ratios and percent changes of staffing levels, ratios of staff/APDC, RN/nurse and licensed nurse/nurse are examined.
Principal Findings: Licensed nursing staff declined while nursing assistants increased in this period. However, the decline in licensed staff positions was not as much as the decline in APDC. With acuity adjustment, there was a slight decrease in RN/APDC, a 23% decrease in LPN/APDC, and a 4% decrease in licensed nurse/APDC. The RN/nurse ratio increased slightly, and licensed nurse/nurse fell slightly. 34% of all hospitals reduced RN/APDC, 64% reduced LPN/APDC, 31% had a decline in RN/nurse, and 45% reduced licensed nurse/nurse.
Conclusions: Since RNs often operate in environments which make use of teams of licensed staff, nurses' perceptions of a decline in the RN/patient ratio is a result of the decline in licensed staff/APDC, of an increase in patient acuity, and of individual hospital reductions.
Learning Objectives: 1. Participants will articulate the reports of nurse staffing downsizing and changes in staff composition. 2. Participants will define measurements of various nursing staff positions in hospitals, adjusted patient days of care, and patient acuity. 3. Participants will describe the changes in levels of nurse staffing, ratios of nursing staff/APDC, and skill mix in Pennsylvania hospitals 1991-1997. 2. Participants will discuss the relationship of these changes to nurses' perceptions of nursing staff reductions and substitutions
Keywords: Nurses, Health Care Restructuring
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.