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European Union

Research teams representing eighteen European countries examined data from hundreds of hospitals, 15,000 nurses, and thousands more patients to study the role nursing work environments and nursing staff deployment play in nurse recruitment, retention, productivity and patient outcomes.


The RN4CAST-EU gives nurse researchers the opportunity to compile and disseminate the evidence for improving nurse retention and patient outcomes.

The Consortium is comprised of nursing and health care researchers, educators and scientists representing a total of eighteen countries, including the USA and three International Cooperating Partner Countries  (ICPC) of the European Union, making it the largest consortium ever in this domain. 

RN4CAST-EU Scientific Papers

The Consortium has achieved the highest number of scientific publications of any study on any topic in EU history. 

Patient safety, satisfaction, and quality of hospital care: Cross-sectional surveys of nurses and patients in 12 countries in Europe and the United StatesBMJ 2012;344:e1717 (2012). Center Authors: Aiken LH, Sloane DM, Smith, HL, Kutney-Lee, A DOWNLOAD

Prevalence, patterns, and predictors of nursing care left undone in European hospitals: Results from the multicountry cross sectional RN4CAST study. BMJ Quality and Safety doi:10.1136/bmjqs-2013-002318 (2013). Center Author: Aiken LH. DOWNLOAD

Nursing skill mix in European hospitals: Cross sectional study of the association with mortality, patient ratings, and quality of care. BMJ Quality & Safety doi:10.1136/bmjqs-2016-05567 (2016). Center Authors: Aiken LH, Sloane D, McHugh M. DOWNLOAD

More sample papers in the literature

Association of nurse staffing and education with hospital mortality in 9 European countriesThe Lancet 383:1824-30 (2014). Center Authors: Aiken LH, Sloane DM, McHugh DOWNLOAD

Organization of hospital nursing, provision of nursing care, and patient assessments of care in Europe. Medical Care Research and Review 72(6):643-664 2015. Center Authors: Smith, H.L., Sloane, D.M., Aiken, L.H. Download

Nurses’ shift length and overtime working in 12 European countries. Medical Care 52(11):975-988 (2014). Center Authors: Aiken, L.H. Download

CHOPR Study findings were highlighted in the NIH/NINR 30th Anniversary BrochureCHOPR Study findings were highlighted in the NIH/NINR 30th Anniversary Brochure30th Anniversary of NINR Notable Advances in Nursing Research