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Nursing Staffing and Hospital Outcomes

Nursing Staffing and Hospital Outcomes. Julie Sochalski, Ph.D., R.N. Center for Health Outcomes and Policy Research University of Pennsylvania. Results of Survey of Hospital Nurses. A survey of over 13,000 staff nurses working in 210 hospitals in Pennsylvania was done in 1999.

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Nursing Staffing and Hospital Outcomes

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  1. Nursing Staffing and Hospital Outcomes Julie Sochalski, Ph.D., R.N. Center for Health Outcomes and Policy Research University of Pennsylvania

  2. Results of Survey of Hospital Nurses • A survey of over 13,000 staff nurses working in 210 hospitals in Pennsylvania was done in 1999. • Over 40% of hospital staff nurses reported being dissatisfied with their current job. • These rates are about 3 times higher than the rates of job satisfaction for workers in general in the U.S. • In addition, 43% of the nurses reported high levels of job burnout . Health Affairs, May-June, 2001, 43-53

  3. Results of Survey of Hospital Nurses(con’t) • Over 80% of the nurses reported that the number of patients they were required to care for had increased in the past year. • Around 45% reported that the quality of patient care at their hospital had deteriorated over the past year. • Only about 1/3 of the nurses reported that the quality of nursing care at their hospital was excellent. • Only 1/3 expressed confidence that their patients were able to manage their own care after being discharged from the hospital. Health Affairs, May-June, 2001, 43-53

  4. Relationship Between Nurse Staffing and Patient Outcomes: Mortality Rates • Nursing workload had a significant impact on patient outcomes in hospitals. • Patient mortality increased 7% for every additional patient that is added to the average nurse’s workload. • Implications: A hospital with an average patient-per-nurse ratio of 8:1 has a 31% higher mortality rate than a hospital with a ratio of 4:1. JAMA, October 23/30, 2002, 1987-1993

  5. Relationship Between Nurse Staffing and Nurse Outcomes: Job Burnout • Nursing workload also had a significant impact on nurse outcomes in hospitals. • Job burnout increased 23% for every additional patient that is added to the average nurse’s workload. • Implications: A nurse working in a hospital with an average patient-per-nurse ratio of 8:1 is more than twice as likely to show high job burnout than a nurse working in a hospital with a ratio of 4:1. JAMA, October 23/30, 2002, 1987-1993

  6. Relationship Between Nurse Staffing and Nurse Outcomes: Job Satisfaction • Nursing workload had similar effects on nurse job satisfaction. • Job dissatisfaction increased 15% for every additional patient that is added to the average nurse’s workload. • Implications: A nurse working in a hospital with an average patient-per-nurse ratio of 8:1 is 75% more likely to be dissatisfied than a nurse working in a hospital with a ratio of 4:1. JAMA, October 23/30, 2002, 1987-1993

  7. Responses to Hospital Nursing Shortages: “Magnet” Hospitals • Responding to a nursing shortage in the early 1980s, the American Academy of Nursing embarked on the “magnet hospital” project Identify hospitals that attract and retain nurses. • Key Magnet Hospital characteristics • nurse autonomy and control over practice • strong nursing leadership • participation in policy-making • career development opportunities • Magnet hospitals also found to have lower patient mortality rates, higher job satisfaction, and lower nurse turnover. McClure & Hinshaw, Magnet Hospitals Revisited, 2002

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