Impact of Nurse Staffing Policy on Nurse Outcomes in Intensive Care Units: A National Longitudinal Study in the United States.

BACKGROUND

To ensure the adequate nurse staffing levels and retain intensive care unit (ICU) nurses, it is important to understand the impact of nurse staffing policies on nurse outcomes during the COVID-19 pandemic.

AIM: This study examined the impact of nurse staffing policies in ICUs on nurse outcomes before and during the COVID-19 pandemic.

STUDY

DESIGN

We conducted a secondary data analysis of a nationally representative sample of nurses working in ICUs. Data from the 2018 (before COVID-19) and 2022 (during COVID-19) National Sample Surveys of Registered Nurses (NSSRN) in the United States were used. The association between nurse staffing policies and nurse outcomes (job satisfaction, turnover and turnover due to burnout and inadequate staffing) in ICUs was examined using logistic regression analysis. A difference-in-differences analysis using the 2018 and 2022 NSSRN datasets was used to examine the longitudinal effects of the policy.

RESULTS

In the state fixed effects model, the nurse staffing policy in ICUs was not significantly associated with the likelihood of job satisfaction. Meanwhile, nurse staffing policy was negatively and significantly associated with nurse turnover. Thus, the presence of a nurse staffing policy may decrease the likelihood of turnover during the COVID-19 pandemic compared to the absence of a nurse staffing policy (β = -0.12, p = 0.013).

CONCLUSIONS

The nurse staffing policy in ICUs effectively reduced turnover during the COVID-19 pandemic. However, it was not significantly associated with job satisfaction, turnover due to burnout and turnover due to inadequate staffing.

RELEVANCE TO CLINICAL PRACTICE: During the COVID-19 pandemic, nurse staffing policies could improve nurse retention in ICUs. To enhance nurses' job satisfaction and reduce burnout, further staffing policy development is necessary to improve the appropriate staffing levels among nurses.