Abstract

Introduction: A Meta-analysis of cross-sectional studies showed that nurse staffing is associated with nurses’ burnout, dissatisfaction, and intent to leave (Shin, 2018). Although these results suggest that staffing improvements would positively affect nurse job outcomes, there is little evidence that captures measures of change. In Chile, before the pandemic, the average patients per nurse assignment was 14 in med-surgical units (Aiken, 2021). During the pandemic, the government allocated resources to improve staffing.

Purpose: To compare pre- and post-pandemic nurse staffing measures in Chilean hospitals and to analyze the effect of these changes on nurses' post-pandemic burnout, dissatisfaction, and intent to leave their jobs.

Methods: Observational, analytical study of repeated cross-sectional measures in the years 2018 and 2023, of public hospitals with more than 150 beds in Chile (n=48). Data was collected through a nurse survey, prior informed consent. Variables of interest: change in staffing (difference in average patients per nurse between 2018 and 2023), burnout score (Maslach's Burnout Inventory), intention to leave, and dissatisfaction. Difference-in-Differences analyses were performed, controlling for baseline 2018 values in nurse outcomes. Linear regression models were used, with 95% confidence, α = 0.05.

Results: 32 hospitals (67%) participated. Between 2018 and 2023, 31 hospitals (97%) improved their staffing, with an average decrease of 4.3 patients per nurse across hospitals. The average burnout score increased from 22.9 to 26.2, intention to leave the job from 32% to 42%, and dissatisfaction from 22.5 to 27.9%. The decrease in patient assignment was significantly associated with burnout scores, dissatisfaction, and intention to leave the job in 2023 (β = 0.42, p = 0.038; β = 0.013, p = 0.01; β = 0.015, p = 0.026, respectively).

Conclusion: After the pandemic, more nurses in Chilean hospitals are burned out, dissatisfied, and want to leave their job. The improvement in staffing did not completely counteract the effect of work overload caused by the pandemic, but the greater the improvement in staffing, the smaller the negative impact of the pandemic on nurse outcomes. A new study, after more years have passed, is likely to fully show the effect of improved staffing on nurse outcomes.

Notes

References:

Aiken, L. H., Simonetti, M., Sloane, D. M., Cerón, C., Soto, P., Bravo, D., ... & Lake, E. T. (2021). Hospital nurse staffing and patient outcomes in Chile: a multilevel cross-sectional study. The Lancet Global Health, 9(8), e1145-e1153.

Shin, S., Park, J. H., & Bae, S. H. (2018). Nurse staffing and nurse outcomes: A systematic review and meta-analysis. Nursing outlook, 66(3), 273–282. https://doi.org/10.1016/j.outlook.2017.12.002

Description

Most evidence analysing the association between nurse staffing and job outcomes comes from cross-sectional studies. Few studies have shown the effect of staffing changes on these outcomes. In Chile, during the pandemic, the government allocated resources to improve nurse staffing. Comparing pre- and post-pandemic measures, most Chilean hospitals have better staffing now. This study shows how staffing improvements partially counteracted the negative effect of the pandemic on nurse outcomes.

Author Details

Marta Simonetti, PhD, APRN, BSN; Alejandra Galiano, MPH, BSN

Sigma Membership

Alpha Beta Omicron

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Meta-Analysis/Synthesis

Research Approach

Quantitative Research

Keywords:

Workforce, Staffing, Policy Advocacy, Leadership Initiatives, Chile

Conference Name

36th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Seattle, Washington, USA

Conference Year

2025

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Click on the above link to access the slide deck.

Share

COinS
 

Effect of Post-Pandemic Nurse Staffing Improvements on Nurse Job Outcomes in Chilean Public Hospitals

Seattle, Washington, USA

Introduction: A Meta-analysis of cross-sectional studies showed that nurse staffing is associated with nurses’ burnout, dissatisfaction, and intent to leave (Shin, 2018). Although these results suggest that staffing improvements would positively affect nurse job outcomes, there is little evidence that captures measures of change. In Chile, before the pandemic, the average patients per nurse assignment was 14 in med-surgical units (Aiken, 2021). During the pandemic, the government allocated resources to improve staffing.

Purpose: To compare pre- and post-pandemic nurse staffing measures in Chilean hospitals and to analyze the effect of these changes on nurses' post-pandemic burnout, dissatisfaction, and intent to leave their jobs.

Methods: Observational, analytical study of repeated cross-sectional measures in the years 2018 and 2023, of public hospitals with more than 150 beds in Chile (n=48). Data was collected through a nurse survey, prior informed consent. Variables of interest: change in staffing (difference in average patients per nurse between 2018 and 2023), burnout score (Maslach's Burnout Inventory), intention to leave, and dissatisfaction. Difference-in-Differences analyses were performed, controlling for baseline 2018 values in nurse outcomes. Linear regression models were used, with 95% confidence, α = 0.05.

Results: 32 hospitals (67%) participated. Between 2018 and 2023, 31 hospitals (97%) improved their staffing, with an average decrease of 4.3 patients per nurse across hospitals. The average burnout score increased from 22.9 to 26.2, intention to leave the job from 32% to 42%, and dissatisfaction from 22.5 to 27.9%. The decrease in patient assignment was significantly associated with burnout scores, dissatisfaction, and intention to leave the job in 2023 (β = 0.42, p = 0.038; β = 0.013, p = 0.01; β = 0.015, p = 0.026, respectively).

Conclusion: After the pandemic, more nurses in Chilean hospitals are burned out, dissatisfied, and want to leave their job. The improvement in staffing did not completely counteract the effect of work overload caused by the pandemic, but the greater the improvement in staffing, the smaller the negative impact of the pandemic on nurse outcomes. A new study, after more years have passed, is likely to fully show the effect of improved staffing on nurse outcomes.