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February 27, 2026JAMA Network Open0 citationsOpen Access

Hospital Nurse Understaffing and Patient Mortality, Readmission, and Length of Stay

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NMNoriko MoriokaMMMutsuko MoriwakiAMAtsushi Miyawaki

Key Points

  • To investigate the impact of nurse understaffing on patient outcomes such as mortality, readmission, and length of stay.
  • Cohort study design focusing on nurse staffing levels during the day shift.
  • Assessment of patient outcomes relating to in-hospital mortality, readmission rates, and length of stay.
  • Monitoring of daily staffing levels to identify understaffing instances.
  • Increased nurse understaffing was associated with a higher risk of in-hospital mortality.
  • Patients were more likely to be readmitted when nurse staffing was inadequate.
  • Length of hospital stay was longer during periods of nurse understaffing.

Abstract

In this cohort study, nurse understaffing during the 24-hour period (specifically during the day shift) was associated with increased risk of in-hospital mortality, hospital readmission, and longer LOS. These findings suggest that close attention to daily staffing levels and prompt action to address understaffing may help improve patient outcomes. Nurse managers should routinely monitor deviations from this benchmark to address immediate needs and enable rapid adjustments through feasible strategies.

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Cite This Study

Morioka et al. (2026) studied this question.

synapsesocial.com/papers/69a1357fed1d949a99abf6a0https://doi.org/10.1001/jamanetworkopen.2025.58235
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