# Presentation: 045166

## Nursing Staffing and Hospital Outcomes

**Julie Sochalski, Ph.D., R.N.**
**Center for Health Outcomes and Policy Research**
**University of Pennsylvania**

**Notes:**
Slide contains a picture of Julie Sochalski.

## 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

**Notes:**
This lists the result of a survey of over 13,000 staff nurses working in 210 hospitals in Pennsylvania that was done in 1999.

## 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

**Notes:**
This continues to list the results of the survey.

## 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

**Notes:**
This details the relationship between nurse staffing in hospitals and the patient “outcome” of mortality.

## 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

**Notes:**
This details the relationship between nurse staffing in hospitals and the nurse “outcome” of job burnout.

## 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

**Notes:**
This details the relationship between nurse staffing and the nurse outcome of “job satisfaction.”

## 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

**Notes:**
This describes “magnet” hospitals, one of the responses to hospital nursing shortages.  Characteristics of a magnet hospital include nurse autonomy and control over practice, strong nursing leadership, participation in policymaking, and career development opportunities.