Nurse staffing and nurse outcomes: A systematic review and meta-analysis

Sujin Shin, Jin Hwa Park, Sung Heui Bae

Research output: Contribution to journalArticlepeer-review

130 Scopus citations


Background: A great number of studies have been conducted to examine the relationship between nurse staffing and patient outcomes. However, none of the reviews have rigorously assessed the evidence about the effect of nurse staffing on nurse outcomes through meta-analysis. Purpose: The purpose of this review was to systematically assess empirical studies on the relationship between nurse staffing and nurse outcomes through meta-analysis. Methods: Published peer-reviewed articles published between January 2000 and November 2016 were identified in CINAHL, PubMed, PsycINFO, Cochrane Library, EBSCO, RISS, and DBpia databases. Findings: This meta-analysis showed that greater nurse-to-patient ratio was consistently associated with higher degree of burnout among nurses (odds ratio: 1.07; 95% confidence interval [CI]: 1.04–1.11), increased job dissatisfaction (odds ratio: 1.08; 95% CI: 1.04–1.11), and higher intent to leave (odds ratio: 1.05; 95% CI: 1.02–1.07). With respect to needlestick injury, the overall effect size was 1.33 without statistical significance. Discussion: The study findings demonstrate that higher nurse-to-patient ratio is related to negative nurse outcomes. Future studies assessing the optimal nurse-to-patient ratio level in relation to nurse outcomes are needed to reduce adverse nurse outcomes and to help retain nursing staff in hospital settings.

Original languageEnglish
Pages (from-to)273-282
Number of pages10
JournalNursing Outlook
Issue number3
StatePublished - 1 May 2018

Bibliographical note

Publisher Copyright:
© 2018 Elsevier Inc.


  • Meta-analysis
  • Nurse outcomes
  • Nurse staffing
  • Nurse-to-patient ratio
  • Systematic review


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