Nurse Staffing Measures

ANA has developed high-impact patient safety measures, with more than two decades of evidence that higher staffing levels are associated with lower rates of patient death and harm. These were the first nursing-sensitive measures developed by ANA, and were prioritized by the Measures Application Partnership (MAP) . MAP recommendations are considered by CMS in proposed patient safety regulations. These measures are in alignment with ANA’s Principles for Nurse Staffing.

Measure Description:

Details of both staffing measures (numerator, denominator, exclusions) are available at the National Quality Forum’s measures website. (Searches can be done via the search box, or by clicking “measure steward” on the left tab and then choosing “American Nurses Association.”).

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.