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Nursing Staffing and Hospital Outcomes

Slide Presentation by Julie Sochalski, Ph.D., R.N.


On April 23, 2003, Julie Sochalski, Ph.D., R.N., made a presentation in the Web-Assisted Audioconference entitled The Nursing Crisis: Improving Job Satisfaction and Quality of Care.

This is the text version of Dr. Sochalski's slide presentation. Select to access the PowerPoint® slides (194 KB).


Nursing Staffing and Hospital Outcomes

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

Slide 1

Nursing Staffing and Hospital Outcomes

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

Slide contains a picture of Julie Sochalski.

Slide 2

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 percent 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 percent of the nurses reported high levels of job burnout.

Source: Health Affairs, May-June, 2001, 43-53.

Slide 3

Results of Survey of Hospital Nurses (continued)

  • Over 80 percent of the nurses reported that the number of patients they were required to care for had increased in the past year.
  • Around 45 percent 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.

Source: Health Affairs, May-June, 2001, 43-53.

Slide 4

Relationship Between Nurse Staffing and Patient Outcomes: Mortality Rates

  • Nursing workload had a significant impact on patient outcomes in hospitals.
  • Patient mortality increased 7 percent 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 percent higher mortality rate than a hospital with a ratio of 4:1.

Source: JAMA, October 23/30, 2002, 1987-93.

Slide 5:

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 percent 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.

Source: JAMA, October 23/30, 2002, 1987-93.

Slide 6

Relationship Between Nurse Staffing and Nurse Outcomes: Job Satisfaction

  • Nursing workload had similar effects on nurse job satisfaction.
  • Job dissatisfaction increased 15 percent 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 percent more likely to be dissatisfied than a nurse working in a hospital with a ratio of 4:1.

Source: JAMA, October 23/30, 2002, 1987-93.

Slide 7

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 to 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.

Source: McClure & Hinshaw, Magnet Hospitals Revisited 2002.

Current as of July 2003


Internet Citation

Nursing Staffing and Hospital Outcomes. Text Version of a Slide Presentation at a Web-assisted Audioconference. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/ulp/workforctel/sess1/sochalskitxt.htm


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