The effect of nurse staffing on patient-safety outcomes: A cross-sectional survey

J Nurs Manag. 2020 Oct;28(7):1758-1766. doi: 10.1111/jonm.13138. Epub 2020 Sep 14.

Abstract

Aim: To analyse the effect of nurse staffing (number of nurses and staff structure) on patient-safety outcomes in hospitals in China.

Background: The number of nurses has been shown to have a significant effect on patient-safety outcomes, but the structure of the nursing staff has received little attention.

Methods: A cross-sectional survey was conducted in 211 units of 13 hospitals. Data on four patient-safety outcomes and numerical and structural indices of nurse staffing were collected from seven types of hospital units.

Results: Nurse staffing had inconsistent effects on units' rates of fall and hospital-acquired pressure ulcers. The nurse-to-patient ratio and rate of nurses with work experience ≤5 years predicted fall rates, and rate of hospital-acquired pressure ulcers was positively correlated to the level of nurse staffing (low nurse-to-patient ratio and high bed-to-nurse number).

Conclusions: The number and structure of nurses are both important to patient safety, and the rate of nurses with work experience ≤5 years might be a protective factor against adverse events.

Implications for nursing management: Patient outcomes correlated with the number and structure of the nursing staff. Methods to balance the structure of nursing staff might be a topic worthy of examination in future studies.

Keywords: cross-sectional studies; nurse staffing; patient safety.

MeSH terms

  • China
  • Cross-Sectional Studies
  • Humans
  • Nurses*
  • Nursing Staff, Hospital*
  • Patient Safety
  • Personnel Staffing and Scheduling
  • Workforce