International research finds quality and safety problems in hospitals throughout 13 countries

In one of the largest studies of its kind, a consortium of investigators from 13 countries led the University of Pennsylvania School of Nursing in the U.S. and the Catholic University of Leuven, Belgium in Europe, found that nurses who reported better working conditions in hospitals and less likelihood of leaving also had patients who were more satisfied with their hospital stay and rated their hospitals more highly. The study was released today in the current issue of the prestigious British Medical Journal.

The massive study, which in some countries involved every hospital, surveyed 61,168 bedside nurses and 131,318 patients in more than 1,000 hospitals in 13 countries over the course of three years, finding that in those hospitals with better work environments and fewer patients in each nurse's , patient and nurses both reported higher standards of care and more satisfied patients.

"Patients in European and U.S. hospitals with better work environments were more likely to rate their hospital highly and to recommend their hospital" to others, wrote the study's lead author, Linda H. Aiken, PhD, RN, a professor of nursing and sociology and director of the Center for and Policy Research at the University of Pennsylvania School of Nursing.

is also a concern in hospitals that have poor work environments and insufficient , said Walter Sermeus, professor at Catholic University of Leuven, Belgium, leader of the European consortium.

Nurses in Poland and Greece were three times more likely to give their hospitals a failing grade for safety than nurses in the U.S. and Norway. The majority of nurses in every country expressed a lack of confidence that hospital management would resolve problems in patient care.

Specifically the researchers found that:

  • High nurse burnout and were common among hospital nurses in Europe and the U.S.
  • On average, only 60 percent of patients were satisfied with their hospital care.
  • Those nurses reporting high levels of burnout (notably in Greece and England) also reported an intention to leave their current positions.
  • Each additional patient added to a nurse's workload increased the odds of a nurse reporting poor or fair quality of care.
  • Patients were less satisfied with their hospital stay in those hospitals that had higher percentages of burnt out or dissatisfied nurses.
Policy implications for the findings suggest that despite the differences among the healthcare systems studied, particularly in terms of both organization and financing, all countries encountered problems of "hospital quality, safety, and nurse and dissatisfaction." Many European nurses report they intend to leave their hospital positions, from 19 percent in The Netherlands to nearly half of all nurses (49 percent) in Finland and Greece, leading the researchers to ponder the potential for a worsening shortage of nurses.

A significantly lower proportion of nurses in the U.S. (14 percent) reported their intentions to leave their current positions, possibly due to increased efforts in the U.S. to improve hospital nurse staffing levels. Having fewer patients per nurse has been linked to better outcomes for patients, including lower rates of death following everyday surgeries. Nearly 7 percent or 400 in the hospitals in the U.S. have achieved "magnet status," so-called due to its ability to attract and retain nurses because of good . No hospital in Europe has a similar "magnet" designation.

More information: The full article can be found at www.bmj.com/content/344/bmj.e1717

add to favorites email to friend print save as pdf

Related Stories

To keep nurses, improve their work environments

Dec 08, 2011

Nurses working in hospitals around the world are reporting they are burned out and dissatisfied with their jobs, reported researchers at the University of Pennsylvania School of Nursing's Center for Health Outcomes and Policy ...

California nurse staffing

Jul 15, 2011

In a comprehensive analysis comparing nurse staffing in California hospitals to similar hospitals in the U.S. over nearly a decade, researchers at the University of Pennsylvania School of Nursing have found that controversial ...

Hospital nurses dissatisfied with health benefits

Feb 14, 2011

Researchers at the University of Pennsylvania have found that nearly 41 per cent of nurses working in American hospitals and health-care settings were dissatisfied with their health-care benefits. The figure is more than ...

Better together - The RN and the EHR

Jan 17, 2012

With the prodding of new federal legislation, electronic health records (EHRs) are rapidly becoming part of the daily practice of hospital nurses – the frontline providers of care. In the first large study of its kind, ...

Recommended for you

With kids in school, parents can work out

20 hours ago

(HealthDay)—Back-to-school time provides an opportunity for parents to develop an exercise plan that fits into the family schedules, an expert suggests.

Obama offers new accommodations on birth control

Aug 22, 2014

The Obama administration will offer a new accommodation to religious nonprofits that object to covering birth control for their employees. The measure allows those groups to notify the government, rather than their insurance ...

Use a rule of thumb to control how much you drink

Aug 22, 2014

Sticking to a general rule of pouring just a half glass of wine limits the likelihood of overconsumption, even for men with a higher body mass index. That's the finding of a new Iowa State and Cornell University ...

User comments