This Is AuburnElectronic Theses and Dissertations

An Examination of the Influence of Nursing Resources and Policies on Care Quality Outcomes




Courtney, Haun

Type of Degree

PhD Dissertation


Political Science

Restriction Status


Restriction Type


Date Available



The nursing shortage has become a top priority in the evaluation of health care quality outcomes. The issue is confirmed by the combination of public availability of care quality ratings in both hospitals and nursing homes as well as the enactment of nursing workforce improvement policy. The included dissertation presents three studies, each with the purpose of extending our understanding of the nursing market and the role that geographical location of nursing resources and nursing workforce improvement policies characteristics play in creating positive (or negative) care quality outcomes. In the pursuit to understand the antecedents and consequences of care quality outcomes, previous scholars have consistently linked outcomes to the nursing supply. However, little is known about the relationship between the supply of nursing education resources and these resource’s locality to hospitals and nursing homes on care quality outcomes. The first study, Examining the Influence of Proximal Density to Nurse School Location on Quality of Care Outcomes ¬in United States Nursing Homes seeks to determine the degree to which proximal density of resources has an effect on care quality outcomes in nursing homes via the use of geographical information system software tools and an ordered logistic analysis. In the second study, Examining the Influence of Proximal Density to Nurse School Location on Quality of Care Outcomes ¬in United States Hospitals, the same relationship is examined but with a focus on hospitals instead of nursing homes. Doing so allows for a more complete view of the nursing market. The third study, Examining the Influence of Nurse Staffing Policy on Nurse Staffing Levels, 2004 - 2016, explores the impact of nurse staffing policy on nurse staffing between 2004 - 2016 via a time series regression analysis. The purpose of this study is to examine if policies are improving nursing supply in both hospitals and nursing homes. The findings of each of these studies extend our appreciation of the role of nursing education resources, health care providers, and those pushing for the enactment of nursing policies that influence care quality outcomes.