Kaiser Permanente and its nurses reached a tentative contract agreement just hours before a one-week extension of their current contract was set to expire.

The breakthrough came Friday, one day after the nurses rallied outside Kaiser Permanente's Moanalua Medical Center to protest what they called unsafe staffing levels at the hospital.

Kaiser Permanente responded by saying that staffing is adequate and that there are quality surveys to prove it.

The staffing issue had remained a stumbling block after other issues, such as a 23-percent pay increase over three years, had been agreed upon, said Aggie Pigao Cadiz, executive director of the Hawai'i Nurses Association, collective bargaining unit for the nurses.

Pigao Cadiz had said nurses wanted more input into the way management deploys nurses at its hospital and clinics, and the ratio of patients to nurses.

The new agreement includes stronger language for Kaiser Permanente to address the issue.

The union also represents nurses at The Queen's Medical Center, Kuakini Medical Center and St. Francis Medical Center, who recently ratified new contracts.