Nurse staffing decisions: an integrative review of the literature.

The author exhaustively explores the current literature and attempts to summarize the current thinking on how to best decide on the most cost-effective nurse staffing requirements. Between 1984 and 1994 FTE nursing employees decreased by 7.3%, causing some researchers to seek ways to explore the relationship between staffing levels, staff and patient satisfaction and outcomes of care. Satisfaction among staff nurses working in a self-scheduling environment was determined largely by the individual's ability to negotiate for the desired days and shifts and by the nurse manager's ability to stand back from the process and let the staff collaboratively work it out. Work structure related studies seemed to find that 12-hour shifts were reported to be "less fatiguing" than traditional 8-hour shifts. Staffing studies found that rural hospitals still used 0.27 more RNs per occupied bed than urban hospitals and that the presence of a unit secretary was associated with a decreased use of RNs.