title: Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees.
abstract: This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives.
authors.affiliation: The University of Texas at Austin, TX, USA tjones0222@aol.com.
authors.forename: Terry
authors.initials: T
authors.lastname: Jones
authors.affiliation: The University of Texas at Austin, TX, USA.
authors.forename: Sung
authors.initials: S
authors.lastname: Heui Bae
authors.affiliation: The University of Texas at Austin, TX, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Murry
authors.affiliation: Texas Woman's University, Denton, TX, USA.
authors.forename: Patti
authors.initials: P
authors.lastname: Hamilton
mesh_terms: D000328:Adult; D026683:Advisory Committees / Q000458:organization & administration*; D000573:American Hospital Association / Q000458:organization & administration; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000600:supply & distribution* / Q000639:trends; D009936:Organizational Innovation; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D015397:Program Evaluation; D011787:Quality of Health Care; D013781:Texas; D014481:United States
keywords: facilities regulation; federal regulation; health-care quality; nursing/health-care workforce issues; rural health; state legislation