title: Recent trends in hospital nurse staffing in the United States.
abstract: 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.
authors.affiliation: Department of Biostatistics and School of Nursing, University of Kansas Medical Center, Kansas City 66160, USA. vstaggs@kumc.edu
authors.forename: Vincent S
authors.initials: VS
authors.lastname: Staggs
authors.forename: Jianghua
authors.initials: J
authors.lastname: He
mesh_terms: D000573:American Hospital Association; D016208:Databases, Factual; D019538:Health Care Surveys; D006801:Humans; D008137:Longitudinal Studies; D009741:Nursing Staff, Hospital / Q000600:supply & distribution* / Q000639:trends; D010561:Personnel Staffing and Scheduling; D019984:Quality Indicators, Health Care; D014481:United States