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Given the economic constraints and efforts to achieve efficiency and effectiveness in health care systems, nurses’ contribution should be analyzed. The Nursing Role Effectiveness Model examines nurses’ contribution to health care based on specific relationships between structure, process and outcome variables. A cross-sectional and longitudinal study was carried out in 26 units of four hospitals in the central region of Portugal to test this model. A total sample of 1764 patients and 364 nurses was obtained. Data were analyzed using SPSS and AMOS 21. The relationships between the variables were tested using the Structural Equation Modelling, indicating a good data fit and statistical significance. In addition to assessing nurses’ contribution, this model underlines the value and effectiveness of nursing care.