Free full text article from JAMA - Hospital Nurse Staffing and Patient
Mortality, Nurse Burnout, and Job Dissatisfaction -
http://jama.ama-assn.org/issues/v288n16/rfull/joc20547.html
ABSTRACT -
Objective  To determine the association between the patient-to-nurse ratio
and patient mortality, failure-to-rescue (deaths following complications)
among surgical patients, and factors related to nurse retention.

Design, Setting, and Participants  Cross-sectional analyses of linked data
from 10 184 staff nurses surveyed, 232 342 general, orthopedic, and vascular
surgery patients discharged from the hospital between April 1, 1998, and
November 30, 1999, and administrative data from 168 nonfederal adult general
hospitals in Pennsylvania.

Main Outcome Measures  Risk-adjusted patient mortality and failure-to-rescue
within 30 days of admission, and nurse-reported job dissatisfaction and
job-related burnout.

Results  After adjusting for patient and hospital characteristics (size,
teaching status, and technology), each additional patient per nurse was
associated with a 7% (odds ratio [OR], 1.07; 95% confidence interval [CI],
1.03-1.12) increase in the likelihood of dying within 30 days of admission
and a 7% (OR, 1.07; 95% CI, 1.02-1.11) increase in the odds of
failure-to-rescue. After adjusting for nurse and hospital characteristics,
each additional patient per nurse was associated with a 23% (OR, 1.23; 95%
CI, 1.13-1.34) increase in the odds of burnout and a 15% (OR, 1.15; 95% CI,
1.07-1.25) increase in the odds of job dissatisfaction.

Conclusions  In hospitals with high patient-to-nurse ratios, surgical
patients experience higher risk-adjusted 30-day mortality and
failure-to-rescue rates, and nurses are more likely to experience burnout
and job dissatisfaction.

Penney Kirby
OHPRS Intranet Facilitator
Ontario Prevention Clearinghouse (OPC)
180 Dundas Street West, Suite 1900
Toronto, Ontario  M5G 1Z8
Tel: 416-408-2249, ext. 242
Fax: 416-408-2122
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