International Journal for Quality in Health Care 14:5-14 (2002)
© 2002 International Society for Quality in Health Care
Hospital staffing, organization, and quality of care: cross-national findings
1Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing
2Department of Sociology, University of Pennsylvania, PA, USA
Based on Dr Aiken’s Plenary Address to the 17th International Conference of the International Society for Quality in Health Care, Dublin, Ireland, September 15, 2000.
Objective. 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 quality of patient care in an international sample of hospitals.
Design. Multisite cross-sectional survey.
Setting. Adult acute-care hospitals in the United States (Pennsylvania), Canada (Ontario and British Columbia), England, and Scotland.
Study participants. 10 319 nurses working on medical and surgical units in 303 hospitals across the five jurisdictions.
Interventions.None.
Main outcome measures. Nurse job dissatisfaction, burnout, and nurse-rated quality of care.
Results. Dissatisfaction, burnout, and concerns about quality of care were common among hospital nurses in all five sites. Organizational/managerial support for nursing had a pronounced effect on nurse dissatisfaction and burnout, and both organizational support for nursing and nurse staffing were directly, and independently, related to nurse-assessed quality of care. Multivariate results imply that nurse reports of low quality care were three times as likely in hospitals with low staffing and support for nurses as in hospitals with high staffing and support.
Conclusion. Adequate nurse staffing and organizational/managerial support for nursing are key to improving the quality of patient care, to diminishing nurse job dissatisfaction and burnout and, ultimately, to improving the nurse retention problem in hospital settings.
Keywords: burnout, health care surveys, health services research, nursing service (hospital), outcome assessment (health care), quality of health care
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