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Nursing Workforce

Hospitals should ensure they have enough nurses and the appropriate mix of nurses (e.g., the number of nurses trained to provide basic patient care like monitoring patient vital signs compared to the number of nurses trained to provide higher level care such as symptom assessment and medication administration) to care for patients in medical, surgical, and med-surg units. In addition, hospitals should ensure that a high percentage of nurses caring for patients throughout the hospital have a bachelors degree in nursing, which results in fewer deaths, shorter hospital stays, and fewer readmissions.

Leapfrog uses the following four measures to assess nursing workforce: 

  1. Nursing and Bedside Care for Patients: Total number of hours that employed or contracted registered nurses (RNs), licensed practical nurses (LPNs), or unlicensed assistive personnel (UAPs) spend providing direct patient care such as nursing rounds, nursing treatments, medication administration, or other direct care to patients in medical, surgical, or med-surg units each day.
  2. Nursing for Patients: Total number of hours that employed or contracted registered nurses (RNs) spend providing direct patients care such as nursing rounds, nursing treatments, medication administration, or other direct care to patients in a medical, surgical, or med-surg units each day.
  3. Percentage of Nursing Staff who are Registered Nurses (RNs): The proportion of nursing hours performed by registered nurses.
  4. Percentage of Registered Nurses (RNs) who have a bachelor's degree in nursing: The proportion of registered nurses who have a Bachelor's of Science in Nursing (BSN) degree or higher educational degree (i.e., master's or doctorate degree in Nursing). 

Reporting Period 

  • Surveys submitted prior to September 1: 01/01/2023 - 12/31/2023
  • Surveys (re)submitted on or after September 1: 07/01/2023 - 06/30/2024

Nurses Included in the Measures

Nursing Hours per Patient Day, RN Hours per Patient Day, Nursing Skill Mix

  • Nurses in single or mixed acuity medical, surgical, or med-surg units only

Percentage of RNs who have a BSN or higher degree

  • Nurses in the hospital, including nurses in observation units, outpatient departments, and emergency departments