Nurse Staffing Measures

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These are high impact patient safety structural measures with more than two decades of evidence providing evidence that higher staffing levels are associated with lower rates of patient death and harm.  They have been identified as priority measures for public reporting to evaluate hospital quality. 

  • These are the first nursing sensitive measures developed by ANA prioritized by the MAP for public reporting
  • MAP recommendations are considered by CMS in proposed rule-making
  • Details are available regarding the robust evidence about the importance of these measures to patient safety on the ANA Staffing webpage: www.nursingworld.org/nursestaffing
  • These measures are in alignment with ANA’s Principles for Safe Staffing

Measure Description:

Details of both staffing measures (numerator, denominator, exclusions) are available at the NQF measures website, the Quality Positioning System at this link: www.qualityforum.org/Qps/QpsTool.aspx (Search can be done by word in the search box, or click of “measure steward”on the left tab and choose ANA.

  • Nursing Hours per Patient Day
    • National Quality Forum (NQF) endorsed, NQ# 0205
    • NQF Description:
      • NSC-13.1 (RN hours per patient day) – The number of productive hours worked by RNs with direct patient care responsibilities per patient day for each in-patient unit in a calendar month.
      • NSC-13.2 (Total nursing care hours per patient day) – The number of productive hours worked by nursing staff (RN, LPN/LVN, and UAP) with direct patient care responsibilities per patient day for each in-patient unit in a calendar month.
      • Measure focus is structure of care quality in acute care hospital units.
  • Skill Mix (RN, LPN, assistive personnel, and contract)
    • NQF endorsed, NQF# 0204
    • NQF Measure Description:
      • NSC-12.1 - Percentage of total productive nursing hours worked by RN (employee and contract) with direct patient care responsibilities by hospital unit.
      • NSC-12.2 - Percentage of total productive nursing hours worked by LPN/LVN (employee and contract) with direct patient care responsibilities by hospital unit.
      • NSC-12.3 - Percentage of total productive nursing hours worked by UAP (employee and contract) with direct patient care responsibilities by hospital unit.
      • NSC-12.4 - Percentage of total productive nursing hours worked by contract or agency staff (RN, LPN/LVN, and UAP) with direct patient care responsibilities by hospital unit.
      • Note that the skill mix of the nursing staff (NSC-12.1, NSC-12.2, and NSC-12.3) represent the proportions of total productive nursing hours by each type of nursing staff (RN, LPN/LVN, and UAP); NSC-12.4 is a separate rate.
      • Measure focus is structure of care quality in acute care hospital units.
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