ABSTRACT
Health care is in crisis. Health care costs continue to rise, while medical errors have become the eighth leading cause of death in the United States (Institute of Medicine [IOM 2000]). A worsening nursing shortage has not improved despite mandated nurse-to-patient ratios (Anderson, 2007). Demographic trends threaten to worsen this crisis; as the U.S. population ages, patient acuity will increase, while the supply of working-age nurses will shrink (U.S. Census Bureau, 2000). A focus on nursing is an essential part of any potential solution to this looming problem. As a large body of literature clearly demonstrates, nurses are inextricably linked to patient outcomes. In short, more nurse hours per patient day are associated with reduced in-hospital mortality (Aiken et al., 1994, 1998, 2002a, 2002b).
