The aim of this dissertation was to examine direct nursing care staffing in nursing homes. Besides considering staffing levels, particular attention was paid to the
competencies, tasks and employment of baccalaureate-educated registered nurses (BRNs), as they are expected to serve as informal leaders with the ability to lead
improvements and redesign practice environments in nursing homes. More specifically, this dissertation aimed to provide insight into 1) the relationship between direct nursing care staffing and staff-related work environment characteristics and quality of care (QoC) in nursing homes; 2) future desirable distinguishing competencies of BRNs in
nursing homes; and 3) how organizations employ BRNs in nursing homes and what is the added value they bring to practice.