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Objectives: This study aimed to systematically review primary studies on the relationship between nurse staffing and hospital readmission. Methods: This study was conducted based on a systematic review of related nursing literature and meta-analysis. The CINAHL, Cochrane Library, DBpia, PubMed, PsycINFO, and RISS databases were searched for either English or Korean language studies published between January 2000 and August 2018 that examined the association between nurse staffing and patient outcomes. Results: Four studies examined the relationship between nurse staffing levels and readmission and all found negative relationships. Current evidence reveals that consistently higher nurse staffing is associated with better patient outcomes. The meta-analysis of 3 studies based on the random effect model showed that the higher nurse staffing level was effective in lowering readmission (odds ratio: 1.06; 95% confidence interval: 1.04-1.08). The meta-analyses revealed a significant increase in readmission in low nurse staffing levels. Conclusions: The findings of this study suggest that sufficient nurse staffing is a strong indicator of the provision of nursing care quality. Continuous effort is recommended to set an optimal patient-to-nurse ratio to formulate guidelines regarding nurse staffing strategies.

Systematic Review of Nurse Staffing Levels and Readmission in Acute Care Hospitals