Primary Care Companion J Clin Psychiatry 2002;4:252-256
© Copyright 2014 Physicians Postgraduate Press, Inc.
Because this piece has no abstract, we have provided for your benefit the first 3 sentences of the full text.
With a growing shortage of hospital nurses and
recent legislation in California requiring minimum ratios of
hospital patients to nurses comes a need to understand the ways
that nurse staffing levels affect patient outcomes and nurse retention
in hospital practice. This study was conducted to determine
the relationship of patient-to-nurse ratio to patient
mortality, failure-to-rescue (deaths following complications)
among surgical patients, and aspects of nurse retention.
Cross-sectional analyses were conducted of linked
data from 10,184 staff nurses who were surveyed; 232,342 general,
orthopedic, and vascular surgery patients discharged from
the hospital between April 1, 1998, and November 30, 1999;
and 168 nonfederal adult general hospitals in Pennsylvania. The
chief outcome measures were risk-adjusted patient mortality
and failure-to-rescue within 30 days of admission as well as job
dissatisfaction and job-related burnout as reported by nurses.
After adjustments were made for patient and hospital
characteristics (the latter included size, teaching status, and
technology), each additional patient per nurse was associated
with a 7% increase in the likelihood of dying within 30 days of
admission (odds ratio [OR] = 1.07, 95% CI = 1.03 to 1.12) and
a 7% increase in the odds of failure-to-rescue (OR = 1.07, 95%
CI = 1.02 to 1.11). After adjustments were made for nurse
and hospital characteristics, each additional patient per nurse
was associated with a 23% increase in the odds of burnout
(OR = 1.23, 95% CI = 1.13 to 1.34) and a 15% increase in the
odds of job dissatisfaction (OR = 1.15, 95% CI = 1.07 to 1.25).
Surgical patients in hospitals with high patientto-
nurse ratios have higher risk-adjusted 30-day mortality and
failure-to-rescue rates; nurses in such hospitals are more likely
to experience job dissatisfaction and burnout.