Demanding safe staffing levels to ensure quality nursing care

Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction

Context The worsening hospital nurse shortage and recent California legislation mandating minimum hospital patient-tonurse ratios demand an understanding of how nurse staffing levels affect patient outcomes and nurse retention in hospital practice. Objective To determine the association between the patient-to-nurse ratio and patient mortality, failure-to-rescue (deaths following complications) among surgical patients, and factors related to nurse retention. Design, Setting, and Participants Cross-sectional analyses of linked data from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular surgery patients discharged from the hospital between April 1, 1998, and November 30, 1999, and administrative data from 168 nonfederal adult general hospitals in Pennsylvania. Main Outcome Measures Risk-adjusted patient mortality and failure-to-rescue within 30 days of admission, and nursereported job dissatisfaction and job-related burnout.

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Journal: JAMA. 2002;288(16):1987-1993.

Authors: Linda H. Aiken, PhD, RN; Sean P. Clarke, PhD, RN; Douglas M. Sloane, PhD; Julie Sochalski, PhD, RN; Jeffrey H. Silber, MD, PhD

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