Article Text

Download PDFPDF
Systematic review
Reviewing the evidence base for nurse staffing and quality of care in nursing homes
  1. Nicholas G Castle
  1. Department of Health Policy&Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Nicholas G Castle
    Graduate School of Public Health, University of Pittsburgh, A610 Crabtree Hall, Pittsburgh 15261, Pennsylvania, USA; CastleN{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Commentary on: OpenUrlCrossRefPubMed

Implications for practice and research

  • There is some evidence that the registered nurse to nursing auxiliary ratio has an impact on the quality of care but further research is needed.

  • There is a need to consider other factors such as staff turnover and the use of agency staff when considering the quality of care in nursing homes (NHs).

  • Further research is needed to identify quality indicators that take into account what is important to residents and their families.

  • There are a number of methodological challenges to undertaking research in this area.


This research comes at a time when NHs are being increasingly asked to do more with less. Revenues for NHs do not appear to be keeping up with inflation. Given that …

View Full Text


  • Competing interests None.