Volume 52 | Number S1 | February 2017

Abstract List

Suhui Li Ph.D., Patricia Pittman, Xinxin Han M.S., Timothy John Lowe


This study examines nurse‐related clinical nonlicensed personnel () in U.S. hospitals between 2010 and 2014, including job categories, trends in staffing levels, and the possible relationship of substitution between this group of workers and registered nurses (s) and/or licensed practical nurses (s).

Data Source

We used 5 years of data (2010–2014) from an operational database maintained by Premier, Inc. that tracks labor hours, hospital units, and facility characteristics.

Study Design

We assessed changes over time in the average number of total hours worked by s, s, and , adjusted by total patient days. We then conducted linear regressions to estimate the relationships between nurse and staffing, controlling for patient acuity, volume, and hospital fixed effects.

Principal Findings

The overall use of and hours per patient day declined from 2010 to 2014, while hours per patient day remained stable. We found no evidence of substitution between and nurses during the study period: Nurse‐related hours were positively associated with hours and not significantly related to hours, holding other factors constant.


Findings point to the importance of examining where and why hours per patient day have declined and to understanding of the effects of these changes on outcomes.