Patient outcomes, practice work environment, staffing adequacy, travel nurse



  1. Vander Weerdt, Candice
  2. Peck, Jessica A.
  3. Porter, Tracy


Background: The unprecedented use of travel and temporary nurses in recent years requires further investigation of the impact on patient care.


Purpose: We conducted a systematic review of empirical research investigating the relationship between travel nurses and patient care to identify if consistent significant associations exist and how structural and process variables may influence such associations.


Methods: A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses of six databases resulted in the identification of 21 relevant articles.


Results: The existing research of travel nurse use differs widely in terms of the definition of travel nurse, study design, and included controls. The literature has failed to establish a consistent relationship between travel nurses and patient outcomes. Adverse associations between travel nursing and patient care may reflect staffing levels or work environments rather than the specific care by the travel nurses themselves.


Practice Implications: Underlying structural and process variables, such as staffing levels and the practice work environment, may be confounding associations between travel nurse usage and quality patient care. Administrators and managers are urged to assess staffing and the work environment when employing travel nurses.