New research conducted by the University of Pennsylvania School of Nursing, and published in Medical Care, shows that creating positive work environments for nurses and higher nurse-to-patient staffing ratios can result in healthier patients and fewer readmissions. Patients recover sooner when they are cared for by an adequately staffed nursing team who feels comfortable and happy in their work environment. nurse job satisfaction

Higher Nurse-to-Patient Ratios Means Lower Mortality

Linda H. Aiken, PhD and her fellow researchers conducted a study, published in the Journal of the American Medical Associationshowing the risks associated with a low nurse-to-patient ratio in a hospital setting. The researchers gathered data from 232,342 patients in various hospitals. After making adjustments for various hospital characteristics, including hospital size and available technology in each hospital, statistics from the data showed that “each additional patient per nurse was associated with a 7% increase in the likelihood of death within 30 days of admission and a 7% increase in the odds of failure-to-rescue.”

Nurses Burn Out Sooner When They Have too Many Duties

The study mentioned above also found that each new patient added to a nurse’s caseload was associated with a 23% increase in the nurse’s sense of “burnout,” and a 15% decrease in the nurse’s job satisfaction. The authors report that a nurse’s perception of insufficient staffing levels also resulted from a lower level of available support staff. Nurses feel discouraged by too many “non-nursing” tasks, including delivering food trays, transporting patients and performing housekeeping chores. Healthcare organizations should consider implementing performance management software for their nursing staff so they can assign, track and evalute the goals set for their nursing staff. By aligning the nursing staff’s day-to-day tasks with organizational goals, such as increasing patient satisfaction, that should help increase employee accountablity and drive employee engagement. 

Higher Nurse-to-Patient Ratios Decreases the Number of Medical Errors

Nursing Research published a study documenting the fact that as the ratio of RNs to patients increased, the number of adverse outcomes decreased. This study completed by Linda H. Aiken, PhD gathered data on the following types of adverse outcomes: medication errors, patient falls, skin breakdown, patient and family complaints, infections and deaths. Every one of the measured areas showed better results when there were more nurses available to care for patients. Another very large study of 5 million medical patients and 1.1 million surgical patients, conducted by the U.S. Agency for Healthcare Research and Quality (AHRQ), found that in hospitals with higher RN staffing ratios, there were better patient outcomes in the areas of UTIs, pneumonia, shock, upper gastrointestinal bleeding and the length of hospital stays. The study noted that higher staffing rates of all kinds of caregivers (not only RNs) was associated with a 2 to 25% improvement in patient outcomes. Three separate studies, funded by the AHRQ noted that pneumonia statistics were uniquely vulnerable to inadequate levels of nursing care. One of these studies indicated that 1 more hour of RN time per patient, per day, resulted in an 8.9% decrease in the likelihood of a surgical patient developing cancer. Along the same lines, another study shows a 9.5% decrease in pneumonia for every 10% increase in nurse staffing levels. In order to ensure that nurse staffing levels are meeting patient needs, hospital’s should consider implementing applicant tracking technology. By utilizing an applicant tracking system, hospital’s will be able to streamline their recruiting processes and ensure that they always have a robust candidate pool of potential nurses to maintain adequate staffing levels.  

Job Satisfaction Among Nurses Can be Improved

A University of Pennsylvania survey of over 13,000 hospital nurses found that only 60% were satisfied with their jobs, and over 33% felt that there were not enough RNs to provide patients with high-quality care. Nurses have a higher than average job dissatisfaction rate due to the demands of their job. A nurse’s level of job satisfaction is an important element in creating positive outcomes for their patients. Therefore, it’s crucial to hire nurses who are more likely act in a positive manner on the job. When healthcare talent acquisition professions utilize behavioral assessments in the hiring process to assess their nurses and direct care workers, they are able to identify people who possess the inherent behavioral competencies needed to succeed. When a candidate completes a behavioral assessment survey, they are being assessed for competencies such as compassion, service-excellence and customer focus, which are all qualities that are likely to contribute to creating a more positive work environment. As Matthew McHugh, study leader and assistant professor at the University of Pennsylvania School of Nursing, said, “Patients are better off in hospitals where nurses are happier doing their job.” 

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About The Editorial Staff

The Editorial Staff is a team of writers with a passion for helping healthcare organizations manage their biggest and most important investment: their employees.