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Original Article

Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction

Korean Journal of Adult Nursing 2016;28(3):256-265.
Published online: June 30, 2016

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2Department of Nursing, Inha University, Incheon

3Department of Nursing, Inha University Hospital, Incheon, Korea

Corresponding author: Lee, Young Whee Department of Nursing, Inha University, 100 Inharo, Nam-gu, Incheon 22212, Korea. Tel: +82-32-860-8202, Fax: +82-32-874-5880, E-mail: ywlee@inha.ac.kr
• Received: February 16, 2016   • Accepted: June 20, 2016

Copyright © 2016 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study examined differences in nursing care activity, work performance outcomes, and job satisfaction associated with upgrading nurse staffing of a nurse-to-patients ratio.
  • Methods
    Descriptive design was used in this study. In total, 148 medical and surgical nurses were recruited from one university hospital. Three instruments were used for data collection: Scale of Nursing Care Activity, Nurses' Work Performance Outcome Measurement Scale and Nurses' Job Satisfaction Scale. Data were analyzed by using descriptive statistics, t-test, ANOVA, and paired t-test.
  • Results
    There were significant differences in nursing care activity (t=-5.06, p<.001), in work performance outcomes (t=-5.46, p<.001) and in job satisfaction (t=4.61, p<.001) when the grading for the nursing staff was changed from three to two indicating increasing number of nurses.
  • Conclusion
    The findings from this study showed that there were more nursing care activities, better work performance outcomes, and higher job satisfaction when numbers of nurses were increased. The changes in the scale to evaluate nursing staff influence nursing activities, work performance and job satisfaction.
Table 1.
Difference es in Work Performance e Outcomes by Gene ral Characteristics of Nurses (N=148)
Characteristics Categories n (%) M±SD t or F p Duncan
Age (year) ≤25a 33 (22.3) 3.75±0.48 18.10 <.001 a<b
26~30a 56 (37.8) 3.91±0.38
≥31b 59 (39.9) 4.26±0.42
Marital status No 92 (62.2) 3.88±0.44 -4.88 <.001
Yes 56 (37.8) 4.24±0.43
Religion Protestant 47 (31.8) 4.07±0.51 0.52 .669
Catholic 22 (14.9) 3.99±0.43
Buddhist 11 (7.4) 3.88±0.49
None 68 (45.9) 4.01±0.45
Education level 3-year programa 42 (28.4) 3.93±0.43 6.42 .002 a<b
4-year programa 84 (56.7) 3.97±0.47
≥Master programb 22 (14.9) 4.33±0.44
Work place Medical ward 73 (49.3) 3.40±0.49 -0.46 .642
Surgical ward 75 (50.7) 4.03±0.46
Career (year) 1~3a 49 (33.1) 3.80±0.44 13.84 <.001 a<b
4~6a 42 (28.4) 3.97±0.43
≥7b 57 (38.5) 4.24±0.43
Table 2.
Comparison of Nursing Care Activity by Nurse Staffing Grade (N=148)
Items 3rd Grade 2nd Grade Difference t p
M±SD M±SD
Nutritional care 2.42±0.97 2.65±0.10 0.23 -2.66 .009
Mouth care 2.20±0.95 2.67±1.12 0.47 -4.34 <.001
Hair care-shampoo 1.37±0.55 1.75±0.88 0.38 -4.24 <.001
Bathing 1.21±0.49 1.53±0.75 0.32 -3.90 <.001
Exchange of linen & clothes 3.17±0.91 3.42±1.02 0.25 -2.61 .010
Suctioning 3.86±0.95 3.99±0.89 0.13 -1.67 .098
Elimination care 2.75±0.94 2.90±0.97 0.15 -1.73 .085
Perineal care 3.50±1.42 4.06±1.25 0.56 -5.76 <.001
Position change 2.84±0.99 3.41±1.09 0.57 -5.62 <.001
Applying cold & hot 3.20±1.05 3.45±0.96 0.25 -2.69 .008
Psychological support for patient & family 3.49±0.92 3.75±0.98 0.26 -2.79 .006
Applying nursing process to patient at high-risk of fall 3.78±1.00 4.02±0.92 0.24 -2.56 .011
Applying nursing process to patient with pain 3.85±0.99 4.09±0.95 0.24 -2.64 .009
Total 2.87±0.53 3.17±0.54 0.30 -5.06 <.001
Table 3.
Comparison of Work Performance Outcomes by Nurse Staffing Grade (N=148)
Items 3rd Grade 2nd Grade Difference t (p)
M±SD M±SD
Nursing practice performance competency 4.04±0.52 4.23±0.45 0.19 -4.34 (<.001)
 Understanding prescription content and performing appropriate tasks without error and omission within given time 4.13±0.65 4.26±0.53 0.13 -2.29 (.023)
 Dealing with and performing many tasks within reasonable time limit 3.86±0.76 4.13±0.64 0.27 -3.69 (<.001)
 Performing accurately according to the guiding principles of medication management 4.36±0.78 4.50±0.54 0.14 -1.98 (.050)
 Possessing knowledge and skills needed to carry out tasks 3.94±0.65 4.14±0.57 0.20 -3.99 (<.001)
 Taking over patients' information accurately during shift change 4.09±0.61 4.32±0.57 0.23 -3.64 (<.001)
 Managing nursing jobs correctly and perfectly 4.03±0.65 4.24±0.57 0.21 -3.36 (.001)
 Accurately recording data according to nursing guide 3.86±0.62 4.00±0.60 0.14 -2.54 (.012)
Nursing practice attitude 3.58±0.66 3.86±0.57 0.28 -4.50 (<.001)
 Showing concern and receptive attitudes to patients and their families 3.69±0.83 3.94±0.65 0.25 -3.52 (.001)
 Bringing harmony among health team members within the department, and promoting a climate of mutual trust and respect with other health team members 3.76±0.74 4.03±0.67 0.27 -3.79 (<.001)
 Giving trust to others as a nurse 3.68±0.72 3.94±0.60 0.26 -4.17 (<.001)
 Taking the initiative and setting an example for others; often seeking additional responsibility 3.21±0.85 3.55±0.79 0.34 -4.28 (<.001)
Nursing practice level promotion 3.48±0.72 3.76±0.71 0.28 -4.54 (<.001)
 Reporting and examining equipment, repair of facilities, machine breakdown and missing 3.49±0.86 3.76±0.88 0.27 -3.45 (.001)
 Completing learning credits to participate in continuing education and crash courses and trying to competency development as a professional nurse 3.60±0.87 3.83±0.87 0.23 -2.74 (.007)
 Identifying the etiology of problems and utilizing methods for solving the problems 3.36±0.85 3.68±0.72 0.32 -4.36 (<.001)
Nursing process application 3.74±0.70 3.99±0.61 0.25 -4.05 (<.001)
 Implementing nursing assessment accurately using instruments of nursing information form 3.79±0.78 4.07±0.74 0.28 -3.67 (<.001)
 After assessing patients, planning and implementing nursing care according to priority 3.76±0.82 4.05±0.68 0.29 -4.10 (<.001)
 Demonstrating and teaching self-care skills to patients and their families 3.66±0.86 3.86±0.77 0.20 -2.38 (.019)
Total 3.79±0.53 4.02±0.47 0.23 -5.46(<.001)
Table 4.
Comparison of Job Satisfaction by Nurse Staffing Grade (N=148)
Items 3rd Grade 2nd Grade Difference t (p)
M±SD M±SD
I am satisfied with my current level of salary 3.15±0.79 2.93±0.72 -0.22 3.55(.001)
I get a chance to improve and stimulate my intelligence in my practice 2.76±0.73 2.61±0.71 -0.15 2.20(.029)
I am satisfied with my current nursing practice 3.10±0.81 2.91±0.77 -0.19 2.76(.006)
My nursing practice requires a lot of skills and special competencies 1.99±0.80 1.98±0.74 -0.01 0.19(.852)
I discuss with my nurse manager about problem and implementation of nursing practice 2.44±0.82 2.34±0.69 -0.10 1.28(.202)
I consider my nursing practice is systematically organized in terms of administration, in order for me to carry out efficient implementation 2.97±0.84 2.72±0.74 -0.25 3.18(.002)
My nurse manager supports my decision related to my practice 2.29±0.73 2.26±0.67 -0.03 0.37(.709)
My workload is appropriate 3.70±0.91 3.14±0.83 -0.56 6.94(<.001)
There is good co-operation with medical professionals in my nursing units 3.27±0.89 3.05±0.88 -0.22 2.30(.003)
There is good co-operation with nurses in my nursing units 2.22±0.75 2.20±0.72 -0.02 0.32(.752)
I will choose to be a nurse again if another opportunity is given to me 3.42±1.09 3.25±1.12 -0.17 1.97(.051)
Total 2.85±0.49 2.67±0.47 -0.18 4.61(<.001)
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    Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction
    Korean J Adult Nurs. 2016;28(3):256-265.   Published online June 30, 2016
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    Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction
    Korean J Adult Nurs. 2016;28(3):256-265.   Published online June 30, 2016
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    Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction
    Differences of Upgrading Nurse Staffing in Nursing Care Activity, Work Performance Outcomes, and Job Satisfaction

    Difference es in Work Performance e Outcomes by Gene ral Characteristics of Nurses (N=148)

    Characteristics Categories n (%) M±SD t or F p Duncan
    Age (year) ≤25a 33 (22.3) 3.75±0.48 18.10 <.001 a<b
    26~30a 56 (37.8) 3.91±0.38
    ≥31b 59 (39.9) 4.26±0.42
    Marital status No 92 (62.2) 3.88±0.44 -4.88 <.001
    Yes 56 (37.8) 4.24±0.43
    Religion Protestant 47 (31.8) 4.07±0.51 0.52 .669
    Catholic 22 (14.9) 3.99±0.43
    Buddhist 11 (7.4) 3.88±0.49
    None 68 (45.9) 4.01±0.45
    Education level 3-year programa 42 (28.4) 3.93±0.43 6.42 .002 a<b
    4-year programa 84 (56.7) 3.97±0.47
    ≥Master programb 22 (14.9) 4.33±0.44
    Work place Medical ward 73 (49.3) 3.40±0.49 -0.46 .642
    Surgical ward 75 (50.7) 4.03±0.46
    Career (year) 1~3a 49 (33.1) 3.80±0.44 13.84 <.001 a<b
    4~6a 42 (28.4) 3.97±0.43
    ≥7b 57 (38.5) 4.24±0.43

    Comparison of Nursing Care Activity by Nurse Staffing Grade (N=148)

    Items 3rd Grade 2nd Grade Difference t p
    M±SD M±SD
    Nutritional care 2.42±0.97 2.65±0.10 0.23 -2.66 .009
    Mouth care 2.20±0.95 2.67±1.12 0.47 -4.34 <.001
    Hair care-shampoo 1.37±0.55 1.75±0.88 0.38 -4.24 <.001
    Bathing 1.21±0.49 1.53±0.75 0.32 -3.90 <.001
    Exchange of linen & clothes 3.17±0.91 3.42±1.02 0.25 -2.61 .010
    Suctioning 3.86±0.95 3.99±0.89 0.13 -1.67 .098
    Elimination care 2.75±0.94 2.90±0.97 0.15 -1.73 .085
    Perineal care 3.50±1.42 4.06±1.25 0.56 -5.76 <.001
    Position change 2.84±0.99 3.41±1.09 0.57 -5.62 <.001
    Applying cold & hot 3.20±1.05 3.45±0.96 0.25 -2.69 .008
    Psychological support for patient & family 3.49±0.92 3.75±0.98 0.26 -2.79 .006
    Applying nursing process to patient at high-risk of fall 3.78±1.00 4.02±0.92 0.24 -2.56 .011
    Applying nursing process to patient with pain 3.85±0.99 4.09±0.95 0.24 -2.64 .009
    Total 2.87±0.53 3.17±0.54 0.30 -5.06 <.001

    Comparison of Work Performance Outcomes by Nurse Staffing Grade (N=148)

    Items 3rd Grade 2nd Grade Difference t (p)
    M±SD M±SD
    Nursing practice performance competency 4.04±0.52 4.23±0.45 0.19 -4.34 (<.001)
     Understanding prescription content and performing appropriate tasks without error and omission within given time 4.13±0.65 4.26±0.53 0.13 -2.29 (.023)
     Dealing with and performing many tasks within reasonable time limit 3.86±0.76 4.13±0.64 0.27 -3.69 (<.001)
     Performing accurately according to the guiding principles of medication management 4.36±0.78 4.50±0.54 0.14 -1.98 (.050)
     Possessing knowledge and skills needed to carry out tasks 3.94±0.65 4.14±0.57 0.20 -3.99 (<.001)
     Taking over patients' information accurately during shift change 4.09±0.61 4.32±0.57 0.23 -3.64 (<.001)
     Managing nursing jobs correctly and perfectly 4.03±0.65 4.24±0.57 0.21 -3.36 (.001)
     Accurately recording data according to nursing guide 3.86±0.62 4.00±0.60 0.14 -2.54 (.012)
    Nursing practice attitude 3.58±0.66 3.86±0.57 0.28 -4.50 (<.001)
     Showing concern and receptive attitudes to patients and their families 3.69±0.83 3.94±0.65 0.25 -3.52 (.001)
     Bringing harmony among health team members within the department, and promoting a climate of mutual trust and respect with other health team members 3.76±0.74 4.03±0.67 0.27 -3.79 (<.001)
     Giving trust to others as a nurse 3.68±0.72 3.94±0.60 0.26 -4.17 (<.001)
     Taking the initiative and setting an example for others; often seeking additional responsibility 3.21±0.85 3.55±0.79 0.34 -4.28 (<.001)
    Nursing practice level promotion 3.48±0.72 3.76±0.71 0.28 -4.54 (<.001)
     Reporting and examining equipment, repair of facilities, machine breakdown and missing 3.49±0.86 3.76±0.88 0.27 -3.45 (.001)
     Completing learning credits to participate in continuing education and crash courses and trying to competency development as a professional nurse 3.60±0.87 3.83±0.87 0.23 -2.74 (.007)
     Identifying the etiology of problems and utilizing methods for solving the problems 3.36±0.85 3.68±0.72 0.32 -4.36 (<.001)
    Nursing process application 3.74±0.70 3.99±0.61 0.25 -4.05 (<.001)
     Implementing nursing assessment accurately using instruments of nursing information form 3.79±0.78 4.07±0.74 0.28 -3.67 (<.001)
     After assessing patients, planning and implementing nursing care according to priority 3.76±0.82 4.05±0.68 0.29 -4.10 (<.001)
     Demonstrating and teaching self-care skills to patients and their families 3.66±0.86 3.86±0.77 0.20 -2.38 (.019)
    Total 3.79±0.53 4.02±0.47 0.23 -5.46(<.001)

    Comparison of Job Satisfaction by Nurse Staffing Grade (N=148)

    Items 3rd Grade 2nd Grade Difference t (p)
    M±SD M±SD
    I am satisfied with my current level of salary 3.15±0.79 2.93±0.72 -0.22 3.55(.001)
    I get a chance to improve and stimulate my intelligence in my practice 2.76±0.73 2.61±0.71 -0.15 2.20(.029)
    I am satisfied with my current nursing practice 3.10±0.81 2.91±0.77 -0.19 2.76(.006)
    My nursing practice requires a lot of skills and special competencies 1.99±0.80 1.98±0.74 -0.01 0.19(.852)
    I discuss with my nurse manager about problem and implementation of nursing practice 2.44±0.82 2.34±0.69 -0.10 1.28(.202)
    I consider my nursing practice is systematically organized in terms of administration, in order for me to carry out efficient implementation 2.97±0.84 2.72±0.74 -0.25 3.18(.002)
    My nurse manager supports my decision related to my practice 2.29±0.73 2.26±0.67 -0.03 0.37(.709)
    My workload is appropriate 3.70±0.91 3.14±0.83 -0.56 6.94(<.001)
    There is good co-operation with medical professionals in my nursing units 3.27±0.89 3.05±0.88 -0.22 2.30(.003)
    There is good co-operation with nurses in my nursing units 2.22±0.75 2.20±0.72 -0.02 0.32(.752)
    I will choose to be a nurse again if another opportunity is given to me 3.42±1.09 3.25±1.12 -0.17 1.97(.051)
    Total 2.85±0.49 2.67±0.47 -0.18 4.61(<.001)
    Table 1. Difference es in Work Performance e Outcomes by Gene ral Characteristics of Nurses (N=148)

    Table 2. Comparison of Nursing Care Activity by Nurse Staffing Grade (N=148)

    Table 3. Comparison of Work Performance Outcomes by Nurse Staffing Grade (N=148)

    Table 4. Comparison of Job Satisfaction by Nurse Staffing Grade (N=148)

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