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  • Title: Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units.
    Author: Cho SH, June KJ, Kim YM, Cho YA, Yoo CS, Yun SC, Sung YH.
    Journal: J Clin Nurs; 2009 Jun; 18(12):1729-37. PubMed ID: 19646118.
    Abstract:
    AIM: To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes. BACKGROUND: Nurse staffing has been reported to influence patient and nurse outcomes. DESIGN: A cross-sectional study with a survey conducted August-October 2007. METHODS: The survey included 1365 nurses from 65 intensive care units in 22 hospitals in Korea. Staffing was measured using two indicators: the number of patients per nurse measured at the unit level and perception of staffing adequacy at the nurse level. Quality of care and job dissatisfaction were measured with a four-point scale and burnout measured by the Maslach Burnout Inventory. Multilevel logistic regression models were used to determine the relationships between staffing and quality of care and job outcomes. RESULTS: The average patient-to-nurse ratio was 2.8 patients per nurse. A fifth of nurses perceived that there were enough nurses to provide quality care, one third were dissatisfied, half were highly burnt out and a quarter planned to leave in the next year. Nurses were more likely to rate quality of care as high when they cared for two or fewer patients (odds ratio, 3.26; 95% confidence interval, 1.14-9.31) or 2.0-2.5 patients (odds ratio, 2.44; 95% confidence interval, 1.32-4.52), compared with having more than three patients. Perceived adequate staffing was related to a threefold increase (odds ratio, 2.97; 95% confidence interval, 2.22-3.97) in the odds of nurses' rating high quality and decreases in the odds of dissatisfaction (odds ratio, 0.30; 95% confidence interval, 0.23-0.40), burnout (odds ratio, 0.50; 95% confidence interval, 0.34-0.73) and plan to leave (odds ratio, 0.40; 95% confidence interval, 0.28-0.56). CONCLUSIONS: Nurse staffing was associated with quality of care and job outcomes in the context of Korean intensive care units. RELEVANCE TO CLINICAL PRACTICE: Adequate staffing must be assured to achieve better quality of care and job outcomes.
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