Effects of nurse staffing and nurse practice environment on quality of nursing care and job outcomes

Objectives: The objective of this study was to analyze the effects of nurse staffing and nurse practice environments on quality of nursing care and job outcomes after accounting for other factors. Methods: The survey included 2,484 nurses from medical/surgical/obstetrics and gynecology care units in 35 general hospitals in Korea. Nurse staffing was measured using the number of beds per nurse at the hospital level. Nurse practice environments were measured using the practice environment scales of the Revised Nursing Work Index. Quality of care and job dissatisfaction were measured with four-point scales and burnout measured by the Maslach Burnout Inventory. Intent to leave their jobs within the next year was also surveyed. Multilevel logistic regression models were used to determine the relationships between nurse staffing and nurse practice environments and quality of nursing care and job outcomes. Results: Nurses included in hospital with high number of bed per nurse were more likely to rate quality of nursing care as low. Nurse staffing had not effect on job outcomes. Nurses with better nurse practice environments were more likely to rate quality of care as high and job outcome as positive. Conclusions: Nurse staffing was associated with quality of nursing care and nurse practice environments a major determinant of patient and nurse outcome. Measures to improve nurse practice environments were needed for improvement of patient and nurse outcomes under considering the context of Korean hospitals.