The Impact of Nurse-to-Patient Ratios on Nurses' Burnout, Job Dissatisfaction, and Intention-to-Leave: A Systematic
Wael Ahmed M Alhazmi1, Montaha Mohamed Ibrahim, Manal S A Hakami
1Author Affiliations: Department of Community Health Nursing and Healthcare, College of Nursing, Umm AlQura University, Makkah, Saudi Arabia (Mr Alhazmi); College of Nursing, King Khalid University, Muhayil, Saudi Arabia (Drs Ibrahim and Awadalkareem); Department of Maternal and Child Health Nursing, Faculty of Nursing, Al-Baha University, Al Bahah, Saudi Arabia (Drs Hakami and Ahmed Mohmmed); Medical Nursing, College of Nursing, Najran University, Najran, Saudi Arabia (Dr Mohamed); Medical-Surgical Nursing Department, College of Nursing, Taibah University, Madinah, Saudi Arabia (Prof Abdelmaksoud); Department of Maternity and Child Nursing, College of Nursing, Taif University, Taif, Saudi Arabia (Dr Mohamed); Department of Clinical Nutrition, Farasan General Hospital, Jazan, Saudi Arabia (Ms Hakami); Department of Laboratory, Farasan General Hospital, Jazan, Saudi Arabia (Ms Mesawa); Department of Mental Health Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia (Dr Mamanao); and Department of Community Health Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia (Prof Fadlalmola).
Background:
Adequate nurse staffing is essential for ensuring workforce well-being and patient safety. Imbalanced nurse-to-patient ratios contribute to burnout, job dissatisfaction, and turnover, which compromise care quality.
Objective:
This systematic review and meta-analysis evaluated the impact of nurse-to-patient ratios on nurse burnout, job dissatisfaction, intention-to-leave, and patient outcomes.
Methods:
A systematic search of PubMed, Scopus, and Web of Science identified cross-sectional studies examining nurse-to-patient ratios and related outcomes.
Results:
Eighteen studies involving 183 876 nurses from 4085 hospitals were included. Higher nurse-to-patient ratios increased the odds of burnout (OR: 1.08), job dissatisfaction (OR: 1.10), and intention-to-leave (OR: 1.09). Each additional patient per nurse increased mortality and readmission risks by 7% to 8%, with decreased perceived care quality.
Conclusion:
Higher nurse-to-patient ratios adversely affect nurses and patients. Ensuring adequate staffing is critical to prevent burnout and maintain safe, high-quality care.
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