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Value of Nurse Practitioner Inpatient Hospital Staffing
Linda H Aiken1,2, Douglas M Sloane1, Heather M Brom1,2,3
1Center for Health Outcomes and Policy Research, The University of Pennsylvania School of Nursing.
Higher nurse practitioner (NP) staffing in hospitals is linked to better patient outcomes, including lower mortality and readmissions. Increased NPs also improve patient experience and nurse job satisfaction.
Area of Science:
- Healthcare Management
- Nursing Practice
- Health Services Research
Background:
- Registered nurse (RN) staffing levels correlate with improved patient outcomes.
- The impact of nurse practitioner (NP) staffing on inpatient outcomes remains largely unexamined.
Purpose of the Study:
- To investigate if increased nurse practitioner (NP) presence in hospitals improves patient outcomes, independent of registered nurse (RN) staffing levels.
Main Methods:
- A 2015-2016 cross-sectional analysis of 579 hospitals using linked data from nurse surveys, patient surveys (HCAHPS), discharge abstracts, Medicare spending reports, and AHA data.
- Hospitals categorized by NP-to-bed ratios: <1 NP/100 beds, 1-2.99 NPs/100 beds, and 3+ NPs/100 beds.
Main Results:
- Hospitals with 3+ NPs/100 beds showed significantly lower 30-day mortality (OR=0.76) and 7-day readmissions (OR=0.90) compared to those with <1 NP/100 beds.
- Higher NP staffing was associated with shorter average length of stay and lower Medicare Spending per Beneficiary (MSPB).
- Patients and nurses reported better care quality and safety in hospitals with higher NP ratios; nurses experienced less burnout and higher job satisfaction.
Conclusions:
- Increased nurse practitioner (NP) staffing positively impacts patient outcomes, nurse satisfaction, and hospital efficiency.
- Nurse practitioners (NPs) enhance the value of existing healthcare labor resources.
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