Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units

다국어 초록 (Multilingual Abstract)

<P>Aim. </P><P>To examine the relationship between nurse staffing and nurse-rated quality of nursing care and job outcomes.</P><P>Background. </P><P>Nurse staffing has been reported to influence patient and nurse outcomes.</P><P>Design. </P><P>A cross-sectional study with a survey conducted August–October 2007.</P><P>Methods. </P><P>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.</P><P>Results. </P><P>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).</P><P>Conclusions. </P><P>Nurse staffing was associated with quality of care and job outcomes in the context of Korean intensive care units.</P><P>Relevance to clinical practice. </P><P>Adequate staffing must be assured to achieve better quality of care and job outcomes.</P>