Impact of Nurse Staffing Impact of Nurse Staffing on Nursing Outcomes on Nursing Outcomes Nurse- -to to- -Patient Ratios: Research and Reality Patient Ratios: Research and Reality Nurse Federal Reserve Bank of Boston Federal Reserve Bank of Boston Massachusetts Health Policy Forum Massachusetts Health Policy Forum March 30, 2005 March 30, 2005 Julie Sochalski, Ph.D. RN Julie Sochalski, Ph.D. RN School of Nursing School of Nursing University of Pennsylvania University of Pennsylvania
Percent of Hospital Nurses Percent of Hospital Nurses with High Job Dissatisfaction with High Job Dissatisfaction 50 41 37 40 33 30 30 17 20 10 0 US Canada Germany UK New Zealand Source: Aiken LH, et al., Health Affairs , May-June, 2001.
Percent of Hospital Nurses Percent of Hospital Nurses with High Job- -Related Burnout Related Burnout with High Job 50 43 40 36 33 33 30 20 15 10 0 US Canada Germany UK New Zealand Source: Aiken LH, et al., Health Affairs , May-June, 2001.
Percent of of Nurses Reporting Percent of of Nurses Reporting Patient Care in Their Hospital is Deteriorating Patient Care in Their Hospital is Deteriorating 50 45 44 40 27 30 25 17 20 10 0 US Canada Germany UK New Zealand Source: Aiken LH, et al., Health Affairs , May-June, 2001.
Percent of Nurses Agreeing Management Will Percent of Nurses Agreeing Management Will Resolve Patient Care Problems Resolve Patient Care Problems 60 50 50 39 37 40 27 27 30 20 10 0 US Canada Germany UK New Zealand Source: Aiken LH, et al., Health Affairs , May-June, 2001.
Relationship Between Nurse Staffing Relationship Between Nurse Staffing and Nurse Outcomes: Job Burnout and Nurse Outcomes: Job Burnout • Nursing workload has significant impact on nurse • Nursing workload has significant impact on nurse outcomes in hospitals. outcomes in hospitals. • Job burnout increased 23% for every additional • Job burnout increased 23% for every additional patient that is added to the average nurse’s workload. patient that is added to the average nurse’s workload. • Implications: A nurse working in a hospital with an A nurse working in a hospital with an • Implications: average patient- -per per- -nurse ratio of 8:1 is more than nurse ratio of 8:1 is more than average patient twice as likely to show high job burnout than a nurse twice as likely to show high job burnout than a nurse working in a hospital with a ratio of 4:1. working in a hospital with a ratio of 4:1. Source: Aiken LH, et al., JAMA , October 23/30, 2002, pp. 1987-93
Relationship Between Nurse Staffing Relationship Between Nurse Staffing and Nurse Outcomes: Job Satisfaction and Nurse Outcomes: Job Satisfaction • Nursing workload had similar effects on nurse job • Nursing workload had similar effects on nurse job satisfaction. satisfaction. • Job dissatisfaction increased 15% for every additional • Job dissatisfaction increased 15% for every additional patient that is added to the average nurse’s workload. patient that is added to the average nurse’s workload. • Implications: A nurse working in a hospital with an A nurse working in a hospital with an • Implications: average patient- -per per- -nurse ratio of 8:1 is 75% more nurse ratio of 8:1 is 75% more average patient likely to be dissatisfied than a nurse working in a likely to be dissatisfied than a nurse working in a hospital with a ratio of 4:1. hospital with a ratio of 4:1. Source: Aiken LH, et al., JAMA , October 23/30, 2002, pp. 1987-93
Relationship Between Nurse Staffing Relationship Between Nurse Staffing and Nurse Outcomes and Nurse Outcomes • Burnout and job satisfaction have effect on • Burnout and job satisfaction have effect on nursing turnover. nursing turnover. • 43% of nurses reporting high levels of burnout • 43% of nurses reporting high levels of burnout and job dissatisfaction intend to leave their jobs in and job dissatisfaction intend to leave their jobs in the next year, compared to 11% of those who are the next year, compared to 11% of those who are not burned out and are satisfied. not burned out and are satisfied. Source: Aiken LH, et al., JAMA , October 23/30, 2002, pp. 1987-93
Frequency of “Great Stress” Reported Frequency of “Great Stress” Reported by Hours worked per Week by Hours worked per Week Scale: “0” = never; “3” = 1- -2x/wk; “5” = almost every day 2x/wk; “5” = almost every day Scale: “0” = never; “3” = 1 4.25 4.03 3.97 4.00 3.91 3.88 3.88 3.75 3.62 3.60 3.50 3.25 3.11 3.00 < 35 35-39 40-44 45-49 50-54 55-59 60-64 65+ Source: USNY State Education Dept., Registered Nurses in New York State, 2002 , September, 2003.
Percent of RNs Reporting Job Dissatisfaction Percent of RNs Reporting Job Dissatisfaction by Overtime Reports, 2002- -03 03 by Overtime Reports, 2002 30 25.7 25 20 13.8 15 10 5 0 Mandatory Overtime No Mandatory Overtime Source: PA Dept. of Health, White Paper: The Nurse Workforce in Pennsylvania, June, 2004.
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