A Proposal for an Improved Nurse Staffing Model for Japanese Hospitals

Author: Satoko Izugami, MSN, RN

Primary Advisor:

Committee Members:

Masters thesis, The University of Texas School of Health Information Sciences at Houston.


Nurse staffing has become one of the crucial indicators of quality of care. Since the 1970s, nurse staffing has been discussed by many researchers from the perspective of scheduling and productivity (McGillis Hall, 2004). Reports by the American Nurses Association (1995) and by the Institute of Medicine (1996) in the United States, examined the influence of nurse staffing on patient outcomes, many researchers changed their research question of nurse staffing studies from the practical issues for nursing administrators to the relation between nurse staffing and patient outcome including patient safety. Many researches stated that nurse staffing affected outcomes for patients, nurses, and hospital (Aiken, Clarke, Sloane, Sochalski, & Silber, 2002; American Nurses Association, 2000; Blegen, Goode, & Reed, 1998; Bloom, Alexander, & Nuchols, 1997; Dunton, Gajewski, Taunton, & Moore, 2004; Kovner & Gergen, 1998; Mark, Harless, McCue, & Xu, 2004; Needleman, Buerhaus, Stewart, Zelevinsky, & Mattke, 2006; Person et al., 2004; Tourangeau, Giovannetti, Tu, & Wood, 2002). Research documenting the relation between nurse staffing and healthcare outcomes have dramatically increased in some countries including the US. However, no research examined Japanese nurse staffing because of differences in healthcare system and in the method of nurse staffing. An improved model for nurse staffing for Japanese nursing should be considered to measure the influence of nurse staffing on healthcare outcomes. The purpose of this paper is to identify necessary measures to evaluate nurse staffing and is to propose an improved model of nurse staffing in Japan.