Staffing and Nurse Practice Environments
Research has demonstrated a correlation between nurse staffing ratios and patient outcomes. According to an integrated analysis by Curtin (2003):
“… research indicates that nurse staffing has a definite and measurable impact on patient outcomes, medical errors, length of stay, nurse turnover, and patient mortality. Moreover, the literature reports data that help determine what is, indeed, appropriate staffing. Ratios are important – a consensus seems to be emerging supporting a range of from 4 to 6 patients per nurse in most acute care hospital inpatient settings, with no more than one to two patients per nurse in areas of high patient acuity. However, ratios must be modified by the nurses’ level of experience, the organization’s characteristics, and the quality of clinical interaction between and among physicians, nurses, and administrators.”
Most research to date has focused on a more general patient population making it difficult to determine the applicability to oncology patient care settings. There is, however, a growing a body of evidence focusing on oncology settings. For more detail on outcomes of care for patients with cancer and the impact of nurse practice environment and staffing ratios, listen to the podcast interview with Christopher Friese, PhD, RN, AOCN®, his research and current literature on this topic.
Additional reading on nurse practice environments, staffing ratios and oncology patient outcomes
Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. JAMA, 288(16):1987-93. (Link to full-text http://jama.ama-assn.org/content/288/16/1987.long)
Curtin, L. (September 30, 2003). "An Integrated Analysis of Nurse Staffing and Related Variables: Effects on Patient Outcomes." Online Journal of Issues in Nursing. Vol. 8 No.3 Available: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/
KeynotesofNote/StaffingandVariablesAnalysis.aspx
Friese, C.R., Lake, E.T., Aiken, L.H., Silber, J.H. & Sochalski, J. (2008). Hospital nurse practice environments and outcomes for surgical oncology patients, Health Research and Educational Trust, 43(4), 1145-63.
Friese, C. R. (2005). Nurse practice environments and outcomes: Implications for oncology nursing, Oncology Nursing Forum, 32(4), 765-772.
Kane, R.L., Shamliyan, T.A., Mueller, C., Duval S. & Wilt, T.J. (2007). The association of registered nurse staffing levels and patient outcomes: systematic review and meta-analysis. Medical Care, 45(12), 1195-204.
Unruh, L. (2008). Nurse Staffing and Patient, Nurse, and Financial Outcomes. American Journal of Nursing. 108(1): 62 - 71.