Nursing staff reductions in Pennsylvania hospitals: exploring the discrepancy between perceptions and data.

Previous research has not confirmed public and practitioner perceptions of a decline in hospital nurse staffing. One reason for this discrepancy is that aggregate or mean values may not be an accurate description of the situation in a sizable percentage of hospitals. This article calculates the mean percentage change in various measures of nursing staff in Pennsylvania hospitals, 1991-1997, and the percentage of hospitals that experienced various degrees of this change. Major findings are that the means of changes in nursing staff understate the declines. When adjusted for patient severity and outpatient care, 50 percent of the hospitals experienced large decreases in RNs per patient days of care, 70 percent had large decreases in LPNs per patient days of care, and 56 percent had large declines in licensed nurses per patient days of care. Overall, the findings support perceptions of a decline in licensed nurse staffing. Policy implications are discussed.