Abstract
Objective: To examine the effects of nurse staffing and organizational support for nursing care
on nurses' dissatisfaction with their jobs, nurse burnout, and nurse reports of quality
of patient care in an international sample of hospitals. Design: Multisite cross-sectional survey Setting: Adult acute-care hospitals in the U.S. (Pennsylvania), Canada (Ontario and British
Columbia), England and Scotland. Study Participants: 10319 nurses working on medical and surgical units in 303 hospitals across the five
jurisdictions. Interventions: None Main outcome measures: Nurse job dissatisfaction, burnout, and nurse-rated quality of care. Results: Dissatisfaction, burnout and concerns about quality of care were common among hospital
nurses in all five sites. Organizational/managerial support for nursing had a pronounced
effect on nurse dissatisfaction and burnout, and both organizational support for nursing
and nurse staffing were directly, and independently, related to nurse-assessed quality
of care. Multivariate results imply that nurse reports of low quality care were three
times as likely in hospitals with low staffing and support for nurses as in hospitals
with high staffing and support. Conclusion: Adequate nurse staffing and organizational/managerial support for nursing are key
to improving the quality of patient care, to diminishing nurse job dissatisfaction
and burnout and, ultimately, to improving the nurse retention problem in hospital
settings.
Nurs Outlook 2002;50:187-94.
Keywords
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Article info
Footnotes
*Reprinted from International Journal for Quality in Health Care; 14, Copyright 2002, Oxford Press. All rights reserved. For the International Hospital Outcomes Research Consortium.
**Forthcoming, International Journal for Quality in Health Care, 2002: 14(1) Do Not Reproduce or Cite Without Authors' Permission Based on Dr. Aiken's Plenary Address to the 17th International Conference of the International Society for Quality in Health Care, Dublin, Ireland, September 15, 2000.
*Reprint requests: Professor Linda Aiken, Center for Health Outcomes and Policy Research, University of Pennsylvania, 420 Guardian Drive, Philadelphia, PA, 19104-6096. Tel: (215) 898-9759, Fax: (215) 573-2062, E-mail: [email protected]
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© 2002 Published by Elsevier Inc.
