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      Outcomes of variation in hospital nurse staffing in English hospitals: Cross-sectional analysis of survey data and discharge records

      , , , , , ,
      International Journal of Nursing Studies
      Elsevier BV

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          Abstract

          Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. To examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurse-rated quality of care. Cross-sectional analysis combining nurse survey data with discharge abstracts. Nurses (N=3984) and general, orthopaedic, and vascular surgery patients (N=118752) in 30 English acute trusts. Patients and nurses in the quartile of hospitals with the most favourable staffing levels (the lowest patient-to-nurse ratios) had consistently better outcomes than those in hospitals with less favourable staffing. Patients in the hospitals with the highest patient to nurse ratios had 26% higher mortality (95% CI: 12-49%); the nurses in those hospitals were approximately twice as likely to be dissatisfied with their jobs, to show high burnout levels, and to report low or deteriorating quality of care on their wards and hospitals. Nurse staffing levels in NHS hospitals appear to have the same impact on patient outcomes and factors influencing nurse retention as have been found in the USA.

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          Author and article information

          Journal
          International Journal of Nursing Studies
          International Journal of Nursing Studies
          Elsevier BV
          00207489
          February 2007
          February 2007
          : 44
          : 2
          : 175-182
          Article
          10.1016/j.ijnurstu.2006.08.003
          2894580
          17064706
          e80ceec5-36c9-492c-9e67-44306d508365
          © 2007

          https://www.elsevier.com/tdm/userlicense/1.0/


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