Date of Conferral

8-4-2026

Date of Award

August 2026

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Corinne Romano

Abstract

This Doctor of Nursing Practice (DNP) project was conducted at an inpatient rehabilitation hospital that provides comprehensive interdisciplinary rehabilitation services for adults. Due to the diverse clinical needs of the rehabilitation patient population, nursing workload varies considerably based on patient acuity, functional status, cognitive impairment, medical complexity, and the intensity of nursing interventions required. This creates a practice gap that contributes to inequitable nursing assignments. A comprehensive literature search was conducted using PubMed, CINAHL, Cochrane Library, and Google Scholar. Nine studies were critically appraised using the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) Evidence Appraisal Tools (Bissett et al., 2025). The literature consistently demonstrates that acuity-based staffing models provide a more objective and equitable method for assigning nursing workloads than traditional nurse-to-patient ratios. The purpose of this DNP project was to develop a program proposal for the delivery of acuity nursing assignments to reduce inequities in patient assignments. The practice focus question is as follows: Will an acuity-based nursing assignment tool reduce inequitable nursing assignments? Outcome measures for the project were improved perceived assignment equity and nurse satisfaction with assignments. Through this initiative, the project aimed to contribute to practice transformation by advancing equitable workload distribution and excellence in nursing practice. Evidence-based nursing assignment tools can make a tangible impact by enhancing the organization's ability to provide equitable, high-quality care to a diverse patient population with varying rehabilitation needs regardless of diagnosis, functional ability, or socioeconomic status.

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