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The quality of care doesn't drop when facilities use temporary nurses to bolster permanent nursing staff, new research suggests. Temporary nurses were defined as those employed by external agencies, internal hospital per diem pools, and permanently employed nurses who float from their regular units. Concerns regarding the use of temporary staff include the potential for less familiarity with facility or unit procedures, disruption in continuity of care, and poor health team communication.

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Researchers used data from the 2000 National Sample Survey of Registered Nurses to determine if the qualifications of temporary staff differed from permanent staff. They also analyzed data from Pennsylvania nurse surveys to see if outcomes and adverse events differed in facilities with varying proportions of temporary and permanent nurses.


Qualifications between temporary and permanent nurses are similar, researchers found, and employing temporary nurses doesn't lower the quality of care. Any association between poor care quality and temporary nurses was explained by poor patient-care environments in facilities employing temporary nurses. For example, more temporary staff was found in facilities where staffing and the adequacy of employee resources rated poorly.


After controlling for adequacy of staffing and resources, higher levels of temporary nurses were associated with lower levels of adverse events.




Aiken LH, et al., Supplemental nurse staffing in hospitals and quality of care, Journal of Nursing Administration, July/August 2007.