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

March 20, 2012

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.

Explore further: To keep nurses, improve their work environments

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

Related Stories

To keep nurses, improve their work environments

December 8, 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

July 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 ...

Better together - The RN and the EHR

January 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, ...

Hospital safety climate linked to both patient and nurse injuries: study

November 7, 2011
A safe working environment for nurses is also a safe environment for the patients in their care, according to a new study led by public health researchers at Drexel University. Researchers, led by Dr. Jennifer Taylor, an ...

RN staffing affects patient success after discharge

April 26, 2011
Higher non-overtime staffing levels of registered nurses lower the probability of patient readmissions to the hospital, a new study finds. However, higher levels of RN overtime increase the likelihood of unplanned visits ...

Recommended for you

Experts devise plan to slash unnecessary medical testing

October 17, 2017
Researchers at top hospitals in the U.S. and Canada have developed an ambitious plan to eliminate unnecessary medical testing, with the goal of reducing medical bills while improving patient outcomes, safety and satisfaction.

New study: Nearly half of US medical care comes from emergency rooms

October 17, 2017
Nearly half of all US medical care is delivered by emergency departments, according to a new study by researchers at the University of Maryland School of Medicine (UMSOM). And in recent years, the percentage of care delivered ...

No evidence that widely marketed technique to treat leaky bladder/prolapse works

October 16, 2017
There is no scientific evidence that a workout widely marketed to manage the symptoms of a leaky bladder and/or womb prolapse actually works, conclude experts in an editorial published online in the British Journal of Sports ...

Ten pence restaurant chain levy on sugary drinks linked to fall in sales

October 16, 2017
The introduction of a 10 pence levy on sugar sweetened drinks across the 'Jamie's Italian' chain of restaurants in the UK was associated with a relatively large fall in sales of these beverages of between 9 and 11 per cent, ...

New exercises help athletes manage dangerous breathing disorder

October 16, 2017
A novel set of breathing techniques developed at National Jewish Health help athletes overcome vocal cord dysfunction and improve performance during high-intensity exercise. Vocal cord dysfunction, now also referred to as ...

Learning and staying in shape key to longer lifespan, study finds

October 13, 2017
People who are overweight cut their life expectancy by two months for every extra kilogramme of weight they carry, research suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.