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Adequate nurse staffing and managerial support foster better patient care and reduce nurse dissatisfaction and burnout

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.

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