Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units

Cho, Sung Hyun; June, Kyung Ja; Kim, Yunmi; Cho, Yong Ae; Yoo, Cheong Suk; Yun, Sung‐Cheol; Sung, Young Hee

doi:10.1111/j.1365-2702.2008.02721.x

Cited by 71 publications

(123 citation statements)

References 28 publications

(65 reference statements)

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“…Among almost 1400 Korean ICU nurses, only one fifth felt that there were enough nurses to provide quality care. One third were dissatisfied, half were burned out and a quarter planned to leave within the year (Cho et al, 2009). Almost 6000 Japanese nurses in another study revealed high burnout-levels; six in ten expressed dissatisfaction with their jobs and a similar proportion reported that quality in their unit could be considered fair or poor (Kanai-Pak et al, 2008).…”

Section: Health Professional Burnout and Qualitymentioning

confidence: 99%

Quality of care and health professional burnout: narrative literature review

Humphries

Morgan

Conry

et al. 2014

International Journal of Health Care Quality Assurance

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Purpose – Quality of care and health professional burnout are important issues in their own right, however, relatively few studies have examined both. The purpose of this paper is to explore quality of care and health professional burnout in hospital settings. Design/methodology/approach – The paper is a narrative literature review of quality of care and health professional burnout in hospital settings published in peer-reviewed journals between January 2000 and March 2013. Papers were identified via a search of PsychInfo, PubMed, Embase and CINNAHL electronic databases. In total, 30 papers which measured and/or discussed both quality of care and health professional burnout were identified. Findings – The paper provides insight into the key health workforce-planning issues, specifically staffing levels and workloads, which impact upon health professional burnout and quality of care. The evidence from the review literature suggests that health professionals face heavier and increasingly complex workloads, even when staffing levels and/or patient-staff ratios remain unchanged. Originality/value – The narrative literature review suggests that weak retention rates, high turnover, heavy workloads, low staffing levels and/or staffing shortages conspire to create a difficult working environment for health professionals, one in which they may struggle to provide high-quality care and which may also contribute to health professional burnout. The review demonstrates that health workforce planning concerns, such as these, impact on health professional burnout and on the ability of health professionals to deliver quality care. The review also demonstrates that most of the published papers published between 2000 and 2013 addressing health professional burnout and quality of care were nursing focused.

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Section: Health Professional Burnout and Qualitymentioning

confidence: 99%

Quality of care and health professional burnout: narrative literature review

Humphries

Morgan

Conry

et al. 2014

International Journal of Health Care Quality Assurance

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“…In addition, not only patients may be harmed, but also the nursing staff may suffer from burnout [13,14], affecting the intent to leave and staff turnover [13]. Nevertheless, overstaffing can lead to a dissipation of funds, which is unacceptable in times of rising demand for efficiency savings.…”

Section: Introductionmentioning

confidence: 99%

Measuring the nursing workload per shift in the ICU

et al. 2012

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Purpose: In the intensive care unit (ICU) different strategies and workload measurement tools exist to indicate the number of nurses needed. The gathered information is always focused on manpower needed per 24 h. However, a day consists of several shifts, which may be unequal in nursing workload. The aim of this study was to evaluate if differences in nursing workload between consecutive shifts can be identified by a nursing workload measurement tool. Methods: The nursing activities score (NAS) was registered per patient for every shift during a 4-week period in a prospective, observational research project in the surgical-pediatric ICU (SICU-PICU) and medical ICU (MICU) of an academic hospital. Results: The NAS was influenced by the patient characteristics and the type of shift. Furthermore, the scores were lower during night shifts, in weekends and in MICU patients. Overall, the mean NAS per nurse per shift was 85.5 %, and the NAS per 24 h was 54.7 %. Conclusion: This study has shown that the nursing workload can be measured per working shift. In the ICU, the NAS differentiates the nursing workload between shifts, patients and units.

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“…One large prospective study of 2323 ICU nurses found associations between intention to leave and professional status ( x = 2.20, SE 0.08; p < .001), nursing leadership ( x = 2.24, SE 0.08; p < .001), staffing and resource adequacy ( x = 2.27, SE 0.06; p < .001), nursing foundations ( x = 2.34, SE 0.06; p < .001), nurse-physician collegiality ( x = 2.51, SE 0.06; p < .001) and rostering flexibility ( x = 2.48, SE 0.09; p < .001) [3] . These associations were also found two ICU studies [48,54] and five studies in acute care settings [42,46,51,55,56] .…”

Section: Intention To Leavementioning

confidence: 54%

“…Emotional exhaustion was explored in fifteen studies, three in ICU [50,52,54] . A significant association was consistently reported between the level of emotional exhaustion, or burn out, by nursing staff.…”

Section: Emotional Exhaustionmentioning

confidence: 99%

“…A significant association was consistently reported between the level of emotional exhaustion, or burn out, by nursing staff. The most frequently reported significant contributing factors to emotional exhaustion were staffing (OR 1.17, 95% CI 1.09-1.25; p < .01) [44] and (OR 050, 95% CI 0.34-0.73; p < .005) [54] , sense of depersonalization (r = -0.576; p < .01) [52] and professional perception of nurses (OR 0.76, 95% CI 0.70-0.82; p < .001) [44] . A recent study concluded that emotional exhaustion is an important predictor of a broad range of nurse outcomes [56] .…”

Section: Emotional Exhaustionmentioning

confidence: 99%

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Selection of an instrument to evaluate the organizational environment of nurses working in intensive care: an integrative review

Abbenbroek

Duffield

Elliott

2014

JHA

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Objective: To determine an appropriate survey instrument to evaluate the impact of organizational structures on the work environment of intensive care nurses. Background:Internationally the demand for intensive care is increasing. Solely increasing bed capacity is not sustainable. Large capacity multi-specialty Intensive Care Units are emerging as the preferred organizational model with benefits resulting from optimizing operational synergies and economies of scale. The impact of this organizational transition on intensive care nurses is not well understood. An appropriate survey instrument for intensive care nurses is required. Design: Integrative literature review. Data Sources: CINAHL, PubMed, EMBASE and OVID Nursing databases searched for studies published between 2005 and 2013.Review methods: An integrative review and quality assessment of the studies was undertaken to select nurse outcome measures associated with organizational structures across a range of acute and critical care settings. Congruence between nurse outcome measures and nurse survey instruments tested in the literature was assessed to select instruments for further psychometric evaluation.Results: Thirty-one cross sectional quantitative studies, from fourteen countries, were reviewed. Twenty one nurse outcome measures associated with organizational factors were identified and a total of twenty five survey instruments used in the studies reviewed. Assessment of congruence and psychometric properties determined that a combination of two instruments is required to comprehensively assess the organizational environment of nurses working in intensive care units. Conclusion:The environment of nurses working in intensive care is effectively evaluated with an instrument that combines subscales from the Practice Environment Scale-Nurse Work Index and Maslach's Burnout Inventory.

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Nurse staffing, quality of nursing care and nurse job outcomes in intensive care units

Abstract: Adequate staffing must be assured to achieve better quality of care and job outcomes.

Cited by 71 publications

References 28 publications

Quality of care and health professional burnout: narrative literature review

Quality of care and health professional burnout: narrative literature review

Measuring the nursing workload per shift in the ICU

Selection of an instrument to evaluate the organizational environment of nurses working in intensive care: an integrative review

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