Association of Nurse Engagement and Nurse Staffing on Patient Safety

Carthon, J. Margo Brooks; Hatfield, Linda; Plover, Colin; Dierkes, Andrew; Davis, L.; Hedgeland, Taylor; Sanders, Anne Marie; Visco, Frank; Holland, Sara B.; Ballinghoff, Jim; Guidice, Mary Del; Aiken, Linda H.

doi:10.1097/ncq.0000000000000334

Cited by 105 publications

(86 citation statements)

References 29 publications

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“…Patient safety could be included in the JD‐R model, as it is an important aspect of organisational outcomes. However, patient safety has never been considered an organisational outcome in organisational psychology models, such as the JD‐R model (Brooks Carthon et al, ; Sloane, Smith, McHugh, & Aiken, ).…”

Section: Introductionmentioning

confidence: 99%

Nurses' mental health and patient safety: An extension of the Job Demands–Resources model

et al. 2020

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Aim We employed the job demands–resources model to examine the impacts of job demands and resources on Chinese nurses' mental health and patient safety. Background Employee mental health and patient safety represent important organisational goals in most hospitals. However, their relationships to insomnia, professional resources and job crafting, as related to the job demands–resources model among nurses, remain unclear. Methods A convenience sample of 2095 registered hospital nurses was recruited from 25 provinces of mainland China from June 2019 to July 2019. Data were collected using self‐reported questionnaires that included the following instruments: the Chinese version of the Athens Insomnia Scale, the Practice Environment Scale of the Nursing Work Index, the Job Crafting Scale, the Emotional Exhaustion Scale, the Utrecht Work Engagement Scale, the General Health Questionnaire and the Safety Attitudes Questionnaire. Results The final model confirmed our hypotheses: burnout mediated the relationship between actual job demands and mental health; work engagement mediated the relationship between perceived job resources and attitudes with regard to patient safety; and job crafting enhanced work engagement and practice environment. Conclusion The job demands–resources model was extended based on the nurses' job characteristics and mental health, as well as patient safety. Implications for Nursing Management These findings may contribute to nursing management strategies that encourage employees to prevent burnout, promote work engagement and job crafting, and in turn promote nurses' mental health and patient safety.

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Section: Introductionmentioning

confidence: 99%

Nurses' mental health and patient safety: An extension of the Job Demands–Resources model

et al. 2020

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“…There is strong evidence over decades internationally showing that patients cared for in hospitals with more patients per nurse have worse outcomes including mortality, adverse events, infections and readmissions, compared with similar patients in hospitals with fewer patients per nurse. [1][2][3][4][5][6][7][8][9][10] Responding to this growing evidence, the International Council of Nurses released a position statement on safe staffing in 2018, encouraging nursing organisations and governments to establish evidence-based staffing systems and policies. 11 A policy intervention often discussed, but rarely implemented is setting minimum nurse-to-patient ratios.…”

Section: Introductionmentioning

confidence: 99%

Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study

et al. 2020

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ObjectivesTo determine whether there was variation in nurse staffing across hospitals in Queensland prior to implementation of nurse-to-patient ratio legislation targeting medical-surgical wards, and if so, the extent to which nurse staffing variation was associated with poor outcomes for patients and nurses.DesignAnalysis of cross-sectional data derived from nurse surveys linked with admitted patient outcomes data.SettingPublic hospitals in Queensland.Participants4372 medical-surgical nurses and 146 456 patients in 68 public hospitals.Main outcome measures30-day mortality, quality and safety indicators, nurse outcomes including emotional exhaustion and job dissatisfaction.ResultsMedical-surgical nurse-to-patient ratios before implementation of ratio legislation varied significantly across hospitals (mean 5.52 patients per nurse; SD=2.03). After accounting for patient characteristics and hospital size, each additional patient per nurse was associated with 12% higher odds of 30-day mortality (OR=1.12; 95% CI 1.01 to 1.26). Each additional patient per nurse was associated with poorer outcomes for nurses including 15% higher odds of emotional exhaustion (OR=1.15; 95% CI 1.07 to 1.23) and 14% higher odds of job dissatisfaction (OR=1.14; 95% CI 1.02 to 1.28), as well as higher odds of concerns about quality of care (OR=1.12; 95% CI 1.01 to 1.25) and patient safety (OR=1.32; 95% CI 1.11 to 1.57).ConclusionsBefore ratios were implemented, nurse staffing varied considerably across Queensland hospital medical-surgical wards and higher nurse workloads were associated with patient mortality, low quality of care, nurse emotional exhaustion and job dissatisfaction. The considerable variation across hospitals and the link with outcomes suggests that taking action to improve staffing levels was prudent.

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“…Leaving the profession generates a permanent loss of resources and an unstable nurse staffing that may compromise patient care [27], i.e. affect patient safety and possibility to provide a good quality care [6,28,29]. The fact that nurses leave the organization has negative consequences for both the individual and society.…”

Section: Introductionmentioning

confidence: 99%

Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey

et al. 2020

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Background: Professional competence and continuous professional development is essential for ensuring high quality and safe nursing care, and it might be important for motivating nurses to stay in the profession. Thus, there is a need to identify the developmental process of nursing competency. Assessment of competence and need for further training helps to identify areas for quality improvement, and to design interventions in order to facilitate continuous competence development in different work contexts. The current study aimed to 1) describe registered nurses' self-assessment of clinical competence as well as the need for further training, and 2) explore possible differences between registered nurses with varying lengths of professional experience as a nurse (≤ 0,5 year, > 0,5-5 years, and ≥ 6 years). Methods: A cross-sectional survey design was applied, using the Professional Nurse Self-Assessment Scale of clinical core competencies II. Registered nurses (n = 266) working in medical and surgical contexts in hospitals in Sweden responded (response rate 51%). Independent student t-test and analysis of variance were carried out. Results: Registered nurses assessed their competence highest in statements related to cooperation with other health professionals; taking full responsibility for own activities; and acting ethically when caring for patients. They assessed their need for further training most for statements related to assessing patients' health needs by telephone; giving health promotion advice and recommendations to patients by telephone; as well as improving a creative learning environment for staff at the workplace. For self-assessed competence and need for further training, differences between the groups for 35 and 46 items respectively, out of 50 were statistically significant. Conclusions: Although the registered nurses assessed their competence high for important competence components expected of professionals such as cooperation with other healthcare professionals, it is problematic that knowledge of interactions and side-effects of different types of medication were reported as having the highest need of training. Longitudinal follow up of newly graduated nurses regarding their continuous development of competence as well as further training is needed.

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Association of Nurse Engagement and Nurse Staffing on Patient Safety

Cited by 105 publications

References 29 publications

Nurses' mental health and patient safety: An extension of the Job Demands–Resources model

Nurses' mental health and patient safety: An extension of the Job Demands–Resources model

Case for hospital nurse-to-patient ratio legislation in Queensland, Australia, hospitals: an observational study

Self-assessed competence and need for further training among registered nurses in somatic hospital wards in Sweden: a cross-sectional survey

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