Date of Conferral



Doctor of Nursing Practice (DNP)




Barbara Niedz


The costs of healthcare in the United States are of national concern. The systematic review of the literature (SRL) explored the practice-focused nursing question regarding the relationship between the use of acuity-based staffing (ABS) models and positive patient outcomes. Analyzing the impact of ABS models on patient quality outcomes and the potential economic value could provide evidence essential for the healthcare executives responsible for fiscally prudent labor management and for creating an evidence-based business case for adequate, patient-centric nurse staffing. The synergy model for patient care and Covell's nursing intellectual capital theory guided the doctoral project. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses systematic review process steps were completed to organize the SRL and report findings. A comprehensive review of the literature yielded 527 articles, with 5 studies that met inclusion criteria in the final review. Analysis and synthesis of the SRL identified several patient outcomes that were significantly correlated with ABS staffing, including medication errors, falls, patient safety incidents, missed care, and mortality. The current body of evidence was insufficiently robust to demonstrate ABS staffing was superior to other nurse staffing models. The implications of this project for positive social change include demonstrating a need for additional research on ABS and the impact of ABS on patient outcomes.