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Hospital Nurse Staffing and Patient Mortality, Emotional Exhaustion, and Job Dissatisfaction

HALM, MARGO PHD, RN, CCRN, BC; PETERSON, MICHELLE MPH; KANDELS, MARY BAN, RN; SABO, JULIE MN, RN, CCRN, BC; BLALOCK, MIRIAM MA, RN; BRADEN, REBECCA BSN, RN; GRYCZMAN, ANNA MSN, RN, PHN, HNC; KRISKO-HAGEL, KATHRYN MS, RN; LARSON, DAVE RN; LEMAY, DIANE RN; SISLER, BETTE RN; STROM, LINDA RN, CNRN; TOPHAM, DEBRA PHD, RN, ACRN, CNS

Continuing Education: CE Feature Article

Objective: To conduct an investigation similar to a landmark study1 that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses.

Methods: Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring for these patients in a large Midwestern institution. The main outcome measures were mortality, failure-to-rescue, emotional exhaustion, and job dissatisfaction.

Results and Conclusions: Staffing was not a significant predictor of mortality or failure-to-rescue, nor did clinical specialty predict emotional exhaustion or job dissatisfaction. Although these findings reinforce adequate staffing ratios at this institution, programs that support nurses in their daily practice and positively impact job satisfaction need to be explored. The Nursing Research Council not only has heightened awareness of how staffing ratios affect patient and nurse outcomes, but also a broader understanding of how the research process can be used to effectively shape nurse's practice and work environments.

From the United Hospital, St. Paul, Minn (Drs Halm and Topham, Mr Larson, and Ms Kandels, Sabo, Blalock, Braden, Gryczman, Krisko-Hagel, Lemay, Sisler, Strom) and the Allina Health System, Minneapolis, Minn (Ms Peterson).

The authors have no conflict of interest.

Grant support for this project was provided by the American Association of Critical-Care Nurses and the Minnesota Nurses Association Foundation.

Corresponding author: Margo A. Halm, PhD, RN, CCRN, BC, United Hospital, 333 N. Smith Ave. St. Paul, MN 55102 (e-mail: Margo.A.Halm@allina.com).

© 2005 Lippincott Williams & Wilkins, Inc.