The purpose of this cross-sectional survey was to assess patient satisfaction and analyze its relationship to nurse staffing levels in 34 inpatient wards at 4 Finnish university hospitals. The patients were satisfied with their care in general. However, the proportion of registered nurses (RNs), the patient-to-RN ratio, and the RNs' working years were highly related to patient satisfaction. Eight patients per RN was the cut-off point for patient satisfaction.

The aim was to assess the interrelationships between nurses' work environment and nursing outcomes. A cross-sectional survey of 664 registered nurses (RN) on 34 acute care inpatient hospital wards was used to measure nurses' perceptions. Patient data (n = 4045) consisting of a total patient satisfaction indicator were collected simultaneously with the nurse data during year 2005. RN's assessments of staffing adequacy, respect and relationships were the most important factors of work environment having an influence on job-related stress, job satisfaction, patient satisfaction and adverse events to patients and nurses. Some 77% of the RN reported adverse nurse events and 96% reported adverse patient events during a 3 month retrospective period. Ensuring sufficient and suitably qualified nurses' availability in delivering nursing care is an important management issue. Nurses are concerned about the quality of care, and the concerns perceived by nurses can influence their clinical work.