What kinds of additional research linking quality and nursing would benefit the field?
A. Much of the work to date has focused on the staff mix and hours of care per patient. Missing from this research has been the hospital and unit context of care—detailed data on the conditions of the patients on the unit, how nurse staffing relates to patient need and the quality of patient care, the physical layout of the unit, the non-nursing staff that contribute to care, and how the care is actually organized. Work has begun on integrating these elements into research on nursing and quality, but more needs to be done. Beyond this, we are confronting a growing shortage of nurses, and I do not expect the gap to be quickly closed. We will need to organize care in hospitals to focus the work of nurses where it will have the most impact, providing direct patient care. We will also need to redesign the care processes and integrate more non-nursing staff into care teams in ways that reduce demands that distract from nursing’s ability to concentrate on the patient. This will allow nurses
