Trends in general acute care hospital nurse staffing from 2017 to 2022.

Background: The COVID-19 pandemic disrupted historical trends in the nursing workforce in the United States.

Objective: This study investigated trends in the utilization of registered nurses (RNs), licensed practical nurses (LPNs), and nursing assistive personnel in short-term general hospitals from 2017 to 2022.

Methods: We used hierarchical linear modeling to investigate the effect of time, hospital characteristics, and geographic characteristics on RN staffing intensity between 2017 and 2022.

Conclusions: Relative to 2017, RN adjusted staffing intensity increased by 0.12 RNs per 1,000 patient days in 2020, (p < .01), but then decreased by 0.11 RNs in 2021 (p < .01), and further decreased by 0.27 RNs per 1,000 patient days in 2022 (p < .01). RN staffing intensity varied significantly by state (p < .05) and LPN full-time equivalents increased by 7% between 2021 and 2022. Conclusions: Our findings suggest that average RN staffing intensity in hospitals decreased in 2021 and 2022, and these effects differed between states.