Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units.
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.
Cho
Sung-Hyun
SH
Department of Nursing, Hanyang University, Seoul, Korea.
June
Kyung Ja
KJ
Kim
Yun Mi
YM
Cho
Yong Ae
YA
Yoo
Cheong Suk
CS
Yun
Sung-Cheol
SC
Sung
Young Hee
YH
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