Nursing: Return on Investment

Liz Westcott, DCM, MSc, DipMan, RNT, RN

Dr. Westcott is the 36th president of Sigma and will preside over the 2025-2027 board of directors. Her Organizational Call to Action is Lead Together.

Return on investment (ROI) is of particular interest to Dr. Westcott as it pertains to the nursing profession. ROI is defined as a performance metric that measures the profitability of an investment by comparing the gain or loss generated against its initial cost. It can also refer to the investment in terms of time and money for staff members and whether that investment has proven to be valuable. In this case, staff members are nurses!

In support of Dr. Westcott's unwavering belief in the value of the nursing profession, the Sigma Repository provides the following ROI Subject Guide. This guide includes:

• Search terms, keywords, and top databases
• Sigma Repository items, and
• External links to pages of interest

Suggested Search Terms and Databases:

Subject Headings:

• Investments, Strategic Planning, Nursing Leaders, Leadership, Health Facilities -- Economics, Medical Organizations -- Economics, Education, Nursing -- Economics, Work Environment -- Economics, Health Facility Costs, Quality of Nursing Care

Keywords:

• Return on Investment, Investing in Nursing, Organizational Perspective, Cost-Benefit Analysis, Costs and Cost Analysis, Cost-Effectiveness Analysis, Workforce

Top Databases:

• CINAHL Complete (EBSCO) $$$ - The world's most comprehensive source of full text for nursing & allied health journals
• EMBASE (Elsevier) $$$- A biomedical research and literature database with over 32 million records for biomedical and pharmacological
• PubMed - Free index to articles covering all aspects of medicine. Developed by the National Center for Biotechnology Information (NCBI)
• Sigma Repository - Free full text gray literature and Open Access articles database dedicated to nursing scholarship. Created by Sigma Theta Tau International the Honor Society of Nursing (Sigma)

$$$ = Subscription required for access

Pertinent Articles, Papers, and Presentations Located in the Sigma Repository:

Have you authored gray literature on this topic? Aware of an on-point Open Access article published under a Creative Commons License? Submit them to the Sigma Repository and help support President Westcott's initiative: https://sigmanursing.formstack.com/forms/sr_submission

External Website and Information Links:

Links are subject to change and are beyond the control of Sigma and the Sigma Repository.

The opinions, advice, and information contained in links, websites, and articles do not necessarily reflect the views or policies of Sigma or the Sigma Repository. Sigma does not warrant that the information is free from errors or omission, or accept any liability in relation to the quality, accuracy, and currency of the information.

• ANCC: Key Initiatives: Economic Value of Nursing - The Economic Value of Nursing initiative reframes how nursing is viewed in the healthcare economy—from being seen primarily as a cost or labor expense to being recognized as a strategic, revenue-generating asset that drives quality care, organizational performance, and financial sustainability. It’s a research effort led by the American Nurses Enterprise Institute for Nursing Research and Quality Management and is structured as a multi-phase, two-year research project.
• Washington State Nurses Association: White Paper: Mapping the Economic Value of Nursing, By David M. Keepnews, PhD, JD, RN, NEA-BC, FAAN - This paper reviews current knowledge and understanding of the economic value of nursing.
• ANPD: NPD in Motion: Beyond Calculation: Empowering Nurse Advocates Through Data-Driven ROI, October 22, 2025, By Emily Calabro, PhD, RN, CCRN, CHPN, CLNC - This article speaks to the silent value of nursing professional development.
• EveryNurse: The Return on Investment (ROI) of Earning a BSN Degree, May 18, 2023, By EveryNurse Staff Members
• Health Policy Watch News: Investments in Healthcare Workforce, Particularly Nurses, Would Yield Tenfold Economic Returns for Global South, Health Systems, December 5, 2024, By Sophia Samantaroy
• AONL: ROI Calculator. This is a subscription-based tool to help nurse executives and hospital leaders turn nursing workforce investments into measurable financial outcomes. This service is listed here for informational purposes only and does not constitute legal/financial/professional advice. No partnership or agency exists between AONL and Sigma.