Quality of Care, Nurse Staffing, and Patient Outcomes

Widespread reports of declining levels of quality of care and patient safety in hospitals, an escalation in calls for legislation mandating minimum nurse staffing ratios, and growing levels of nurse burnout and a looming nursing shortage have focused attention on the working conditions that nurses face and their implications for patient outcomes. This article reports on the preliminary results of an international study on how nurse staffing levels and the nursing practice environment affect the quality of care and patient outcomes in hospitals. Surveys of staff nurses working in acute care hospitals in Pennsylvania reveal that one out of every five staff nurses reported the quality of care on their unit as fair or poor. Workload played a role in these quality assessments, but it was the consequences of workload, such as the reports of unfinished nursing at the end of the last shift and the frequency of adverse events among patients, that played a much more prominent role.