Hospital nursing, care quality, and patient satisfaction: Cross-sectional surveys of nurses and patients in hospitals in China and Europe

You, Liming; Aiken, Linda H.; Sloane, Douglas M.; Liu, Ke; He, Guoping; Hu, Yan; Jiang, Xiaolian; Li, Xiaohan; Li, Xiaomei; Liu, Huaping; Shang, Shaomei; Kutney‐Lee, Ann; Sermeus, Walter

doi:10.1016/j.ijnurstu.2012.05.003

Cited by 285 publications

(346 citation statements)

References 18 publications

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“…A systematic review of research confirming the relationship between low nurse staffing levels and adverse patient outcomes found 101 studies published up to 2006, mainly from the USA (Kane et al, 2007). Major studies have continued to be undertaken in countries around the world including Australia (Twigg et al, 2011), China (You et al, 2013), England (Rafferty et al, 2007), Thailand (Sasichay-Akkadechanunt et al, 2003) and across 12…”

Section: Introductionmentioning

confidence: 99%

Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development

Griffiths

Ball

Drennan

et al. 2016

International Journal of Nursing Studies

218

216

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What is already known? A number of high quality reviews establish an association between lower registered nurse staffing levels, increased mortality rates and other adverse outcomes  Careful analysis of this evidence suggests that it is consistent with a causal relationship  Translation of this evidence into practice is disputedWhat this paper adds  This paper summarises and extends a recent systematic review on nurse staffing and outcomes undertaken for England's National Institute for Health and Care Excellence  Methodological limitations mean that existing studies may not give unbiased estimates of the benefits from increased nurse staffing, with over and underestimation of benefit both possible, which makes it difficult to directly translate evidence into guidance for practice. We identify avenues for progressing this important research so that future studies might be better able to provide the evidence needed to inform policy and practice, and provide a checklist to aid future study development AbstractA large and increasing number of studies have reported a relationship between low nurse staffing levels and adverse outcomes, including higher mortality rates. Despite the evidence being extensive in size, and having been sometimes described as "compelling" and "overwhelming", there are limitations that existing studies have not yet been able to address. One result of these weaknesses can be observed in the guidelines on safe staffing in acute hospital wards issued by the influential body that sets standards for the National Health Service in England, the National Institute for Health and Care Excellence (NICE), which concluded there is insufficient good quality evidence available to fully inform practice.In this paper we explore this apparent contradiction. After summarising the evidence review that informed the NICE guideline on safe staffing and related evidence, we move on to discussing the complex challenges that arise when attempting to apply this evidence to practice. Among these, we introduce the concept of endogeneity, a form of bias in the estimation of causal effects. Although current evidence is broadly consistent with a cause and effect relationship, endogeneity means that estimates of the size of effect, essential for building an economic case, may be biased and in some cases qualitatively wrong. We expand on three limitations that are likely to lead to endogeneity in many previous studies: omitted variables, which refers to the absence of control for variables such as medical staffing and patient case mix; simultaneity, which occurs when the outcome can influence the level of staffing just as staffing influences outcome; and common-method variance, which may be present when both outcomes and staffing levels variables are derived from the same survey.Thus while current evidence is important and has influenced policy because it illustrates the potential risks and benefits associated with changes in nurse staffing, it may not provide operational solutions. We conclude by posing a ser...

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Section: Introductionmentioning

confidence: 99%

Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development

Griffiths

Ball

Drennan

et al. 2016

International Journal of Nursing Studies

218

216

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“…(4)(5)(6)(7) Positive practice environments are also associated with the positive assessment of the quality of nursing care, (7)(8)(9) a higher level of job satisfaction, (7)(8)10) a lower level of burnout and lesser intention to leave the job or the profession. (8,10,11) Other studies highlight that the increased proportion of nurses and improvements in the environment of professional practice can also be associated with the positive assessment of patient safety, (12,13) with the patients' increased satisfaction level (7,14) and decreased mortality at the institutions. (4,5) In Latin America, however, studies to assess the nursing practice environment are still incipient and, in Brazil, the studies are concentrated in the Southeast.…”

Section: Introductionmentioning

confidence: 99%

Ambiente da prática, satisfação e clima de segurança: percepção dos enfermeiros

Dorigan

Guirardello

2017

Acta paul. enferm.

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Objective: To assess the nurses' perception on the practice, job satisfaction, safety climate and to verify correlations among these variables and the adequacy of material and human resources, as well as the intention to stay at the institution and in the profession. Methods: A descriptive study with a quantitative approach was undertaken. To calculate the sample, a p-coefficient of 0.50 was considered, assuming a 3% sampling error and a 5% significance level, which resulted in 1057 subjects. For the data collection, a characterization form was used, which contained the variables sex, monthly income, length of experience at the institution, existence of another employment bond and weekly hour load. A Likert-type response scale was used. The Nursing Work Index -Revised (NWI-R) was used to assess the nurse's perception on the practice. Results: The nurses' perception of the practice environment is positive, except in the control over the work environment domain. They assessed the safety climate as negative and are dissatisfied at work. A strong negative correlation was identified between control over the work environment and the adequacy of the number of professionals, as well as a strong positive correlation between job satisfaction and the intention to stay at the institution. Conclusion: The nursing work environment was assessed as favorable, except for control over the work environment, mainly influenced by the insufficient number of nursing professionals. The safety climate was perceived as unfavorable at the different health care institutions in the State of São Paulo and the nurses did not report job satisfaction. ResumoObjetivo: Avaliar a percepção dos enfermeiros sobre o ambiente da prática, satisfação no trabalho, clima de segurança e verificar correlações entre essas variáveis e adequação de recursos materiais e humanos, e intenção de permanecer na instituição e na profissão. Métodos: Trata-se de um estudo de abordagem quantitativa, do tipo descritivo. Para o cálculo da amostra foi considerada uma proporção p igual a 0,50, assumindo-se um erro amostral de 3% e nível de significância de 5%, que resultou em 1057 sujeitos. Utilizou-se para a coleta de dados a ficha de caracterização contendo as variáveis sexo, renda mensal, tempo de trabalho na instituição, existência de outro vínculo empregatício e carga horária semanal. A escala de resposta foi do tipo Likert. O Nursing Work Index -Revised (NWI-R) foi utilizado com a finalidade de avaliar a percepção do enfermeiro quanto ao ambiente da prática. Resultados: Os enfermeiros possuem percepção positiva do ambiente, exceto para o controle, avaliaram o clima de segurança como desfavorável e estão insatisfeitos no trabalho. Identificou-se forte correlação negativa entre controle sobre o ambiente e adequação do número de profissionais e forte correlação positiva entre satisfação no trabalho e intenção de permanecer na instituição. Conclusão: O ambiente da prática foi avaliado pelos enfermeiros como favorável, exceto para o controle sobre o ambiente, influ...

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“…Observa-se na literatura que instituições mais organizadas, que investem no desenvolvimento dos fatores relacionados ao ambiente das práticas profissionais, como a organização do tempo para o cuidado, oportunidades de aprendizado, crescimento profissional e o preparo para participar das tomadas de decisões também resultaram em aumento da satisfação profissional, menor turnover e melhora da segurança do paciente 130,[148][149] .…”

Section: Consórcio Brasileiro De Acreditação E a Canadian Council On unclassified

“…A análise da importância atribuída aos domínios da satisfação profissional pelos profissionais apresentou a remuneração (3, 18,20,105,115,[117][118]138,149 .…”

Section: íNdice De Satisfação Profissional (Isp)unclassified

“…Assim, corroborando com os achados deste estudo, encontra-se na literatura diversas pesquisas que associaram significativamente o ambiente das práticas profissionais de enfermagem com a satisfação profissional 18,20,105,115,138,149 . Conforme encontrado por Aiken (2008) 18 , enfermeiros que trabalham em ambiente favorável às práticas de enfermagem têm 25% mais chance de estarem satisfeitos profissionalmente.…”

Section: íNdice De Satisfação Profissional (Isp)unclassified

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Segurança do paciente em unidades de terapia intensiva: ambiente das práticas profissionais de enfermagem e satisfação profissional na ocorrência de eventos adversos

Oliveira¹

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Hospital nursing, care quality, and patient satisfaction: Cross-sectional surveys of nurses and patients in hospitals in China and Europe

Cited by 285 publications

References 18 publications

Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development

Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the National Institute for Health and Care Excellence Safe Staffing guideline development

Ambiente da prática, satisfação e clima de segurança: percepção dos enfermeiros

Segurança do paciente em unidades de terapia intensiva: ambiente das práticas profissionais de enfermagem e satisfação profissional na ocorrência de eventos adversos

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