title: Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  Adequate staffing must be assured to achieve better quality of care and job outcomes.
authors: Department of Nursing, Hanyang University, Seoul, Korea.
authors: Sung-Hyun
authors: SH
authors: Cho
authors: Kyung Ja
authors: KJ
authors: June
authors: Yun Mi
authors: YM
authors: Kim
authors: Yong Ae
authors: YA
authors: Cho
authors: Cheong Suk
authors: CS
authors: Yoo
authors: Sung-Cheol
authors: SC
authors: Yun
authors: Young Hee
authors: YH
authors: Sung
mesh_terms: D000328:Adult; D002983:Clinical Competence / Q000592:standards* / Q000706:statistics & numerical data; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D003625:Data Collection; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000592:standards / Q000706:statistics & numerical data*; D007588:Job Satisfaction; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000706:statistics & numerical data; D016017:Odds Ratio; D011787:Quality of Health Care / Q000592:standards* / Q000706:statistics & numerical data; D012044:Regression Analysis; D056910:Republic of Korea; D011795:Surveys and Questionnaires