Nurse staffing and hospital‐acquired conditions: A systematic review

AIMS AND OBJECTIVES: To systematically review and synthesise primary studies on the relationship between nurse staffing and hospital-acquired conditions. BACKGROUND: Research examining the association between nurse staffing and hospital-acquired conditions is varied owing to the use of different definitions and methods. DESIGN: This study was conducted based on a systematic review of related nursing literature. METHODS: The CINAHL, Cochrane Library, DBpia, EBSCO, PubMed, PsycINFO and RISS databases were searched for either English or Korean language studies published between January 2000 and August 2018 that examined the association between nurse staffing and hospital-acquired conditions. We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses check list. RESULTS: Totally, 19 published studies were included in the systematic review. Various measures were used to examine association between nurse staffing and hospital-acquired conditions. The majority of the reviewed studies revealed negative relationships between nurse staffing levels and hospital-acquired conditions. However, a substantial number of relationships were not significant. CONCLUSIONS: There is a need for future studies to examine the differences in the relationship between nurse staffing and hospital-acquired conditions and to use precise data collection on registered nurses' hours per patient day and total hours per patient day, as it is difficult to collect data on these measures. The findings of this study suggest that sufficient nurse staffing is a strong indicator of the provision of quality patient care. However, continuous efforts are recommended to find more conclusive relationships between nurse staffing and hospital-acquired conditions and to formulate guidelines regarding nurse staffing strategies. RELEVANCE TO CLINICAL PRACTICE: Nurse staffing is an important managerial strategy. Especially, given health policy changes, hospitals need to develop staffing strategies to prevent hospital-acquired conditions.