The impact of nurse staffing on turnover and quality: An empirical examination of nursing care within hospital units

Abstract

Inadequate nurse staffing continues to challenge healthcare delivery in the United States. In this research, we undertake a fine‐grained, unit‐level analysis to understand the relationships between nurse staffing, nurse turnover, and pressure ulcers, the latter of which is a key nursing‐sensitive care quality indicator. We examine these relationships within two types of hospital units: intensive care units (ICUs) and medical‐surgical (MedSurg) units, which have unique patient mixes and needs. Using hospital unit‐level data between 2008 and 2017, we show that nurse staffing primarily affects nurse turnover in ICUs, and that the adverse effects of nurse turnover on care quality tend to be stronger in ICUs than in MedSurg units. These findings provide important theoretical insights into the varying roles of staffing, turnover, and quality across organizational units. The findings suggest that hospital administrators may prioritize staffing needs for ICUs over MedSurg units to maintain strong quality performance on measures such as pressure ulcers. Further, our study reveals that staffing requirements for ICUs may be inadequate compared with MedSurg units. Thus, there is a need to evaluate existing guidelines on ICU staffing.

How and why strengths-based leadership relates to nurses’ turnover intention: the roles of job crafting and work fatigue

“…Retaining and maintaining enough well-qualified nurses is quite important for hospitals to provide high-quality nursing services for patients (Engstr€ om et al, 2022). Unfortunately, more and more nurses have chosen to leave their current hospital in the past several decades (Peng et al, 2023), which causes various problems for hospitals such as increased recruitment costs and poor quality of patient care (Muir et al, 2022), and sometimes even impedes the sustained development of the hospitals (Sawada et al, 2022). In order to prevent nurses from leaving their organizations, identifying the influencing factors of turnover has been one of the crucial research themes in the field of nursing management ( € Ozkan, 2022).…”

“…, 2022). Unfortunately, more and more nurses have chosen to leave their current hospital in the past several decades (Peng et al. , 2023), which causes various problems for hospitals such as increased recruitment costs and poor quality of patient care (Muir et al.…”