hospital staffing issues - nurse retention
Nearly one-fifth (18 percent) of patients in the United States
and England and more than one-fourth (27 percent) of patients in
Canada rated their last hospital stay as fair or poor. Physicians
in these countries agree that hospital quality of care is
threatened by shortages of nurses. Yet nurse burnout,
dissatisfaction, and shortages in the countries studied are at an
all time high, and prospects of recruiting more nurses are dim.
Adequate nurse staffing and organizational/ managerial support
for nursing are keys to decreasing nurse job dissatisfaction and
burnout and ultimately to retaining more hospital nurses and
improving the quality of patient care. That's the conclusion of
Linda H. Aiken, Ph.D., R.N., of the University of Pennsylvania
School of Nursing, and other members of the International Hospital
Outcomes Research Consortium, which is supported in part by the
Agency for Healthcare Research and Quality in collaboration with
the National Institute of Nursing Research (NR04513).
Dr. Aiken and her colleagues surveyed 10,319 nurses in 303
hospitals in five sites (United States, Pennsylvania; Canada,
Ontario and British Columbia; England; and Scotland) to examine
the effects of nurse staffing and organizational support for
nursing care on nurses' dissatisfaction with their jobs, nurse
burnout, and nurse reports of care quality. Dissatisfaction,
burnout, and concerns about care quality were common among
hospital nurses in all five sites.
The percent of nurses with burnout scores above published norms
for medical personnel varied from 54 percent of nurse respondents
in Pennsylvania to 34 percent in Scotland. Nurse reports of low
quality of care (in their units and on their last shift) were
three times as likely in hospitals with low staffing and support
for nurses as in hospitals with high staffing and support. Also,
nurses working in hospitals with weak organizational support for
nursing care were twice as likely to report dissatisfaction with
their jobs and to have burnout scores above published norms for
medical personnel.
See "Hospital staffing, organization, and quality of care:
Cross-national findings," by Dr. Aiken, Sean P. Clarke, R.N.,
Ph.D., and Douglas M. Sloane, Ph.D., in the September 2002
Nursing Outlook 50(5), pp. 187-194.
Editor's Note: This study appeared originally in the
January 2002 issue of the International Journal for Quality in
Health Care 14(1), pp. 5-13.
Reprints available from the AHRQ Publications Clearinghouse.
These are excerpts from the AHRQ Research Activities,
you can read the full report at
http://www.ahrq.gov/research/apr03/0403RA21.htm |