Observational studyJournal of advanced nursing2025
Planned Changes to Nurse Leadership, Staffing and Skill-Mix: Impact on the Working Environment, Job Satisfaction and Intention to Leave.
Observational study in Journal of advanced nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Organisational interventions in nursing care: A scoping review and descriptive system to support comparison.International journal of nursing studies advances · 2026Article
- The Associations Between Nurses' Perceived Adequacy of Staffing and Quality of Nursing Care and Job Enjoyment: A Multilevel Modelling Approach.Journal of advanced nursing · 2026Observational
- Reflections and Projections: The Next 50 Years of Priorities in Nursing Education.Journal of advanced nursing · 2026Article
- Job Satisfaction Among Nursing Staff: A Cross-Sectional Study in Slovenian Healthcare Settings.Nursing reports (Pavia, Italy) · 2026Article
- Staying Despite the Intention to Leave: Insights from Frontline Nurses and Nurse Managers from a Qualitative Descriptive Study.Nursing reports (Pavia, Italy) · 2026Article
- What changes does rural medical education need?--a qualitative study exploring the experiences of rural grassroots doctors.BMC medical education · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
Abstract
introductionJob satisfaction and intention to leave have been consistently linked to the working environment. However, there are few studies of interventions for improving the environment or staff outcomes.
aimTo determine the impact of implementing a framework for safe nurse staffing on the environment and staff outcomes. This involved an assessment of required nursing hours per patient day, supernumerary nurse in charge and minimum 80:20 skill-mix, with intentional changes in staffing if required.
designA pre-post observational design.
methodsThis was a prospective observational study in six medical and/or surgical wards across three acute hospitals in Ireland. The outcomes were measured pre- and post-implementation, and included the environment, using the Practice Environment Scale of the Nursing Work Index; and job satisfaction and intention to leave using a dichotomised 4-point scale. OUTCOMES: Changes in staffing levels, adjustments to skill-mix and the supervisory role of the ward leader were seen following the implementation. A multilevel model found significant increases over time on three of the five Nursing Work Index subscales: Staffing and Resource Adequacy, Collegial Nurse-Physician Relations, and Nurse Participation in Hospital Affairs. Job satisfaction increased and intention to leave decreased, although the differences were not statistically significant. Increased job satisfaction was significantly associated with Staffing and Resource Adequacy, Collegial Nurse Physician Relations and Nurse Manager, Leadership and Support. A decreased odds of intention to leave was associated with increased job satisfaction.
conclusionThere were significant improvements in the environment following the implementation of the Framework. Three of the practice environment subscales were significantly associated with job satisfaction, while job satisfaction is a predictor of intention to stay. This study indicates that intentional changes to staffing can result in improvements to working environments which may in turn have an impact on job satisfaction and furthermore, on intention to stay. IMPACT: This study investigated intentional changes to nurse staffing in medical and surgical wards, examining the impact pre- and post-implementation. This study underlined that when staffing is based on a systematic approach, based on a Framework for Safe Nurse Staffing, a subsequent improvement can be seen in staff's perceptions of the work environment, along with improvements in staff outcomes. This research will impact on staff working in acute settings as a means of determining staffing and improving outcomes using a Framework for Safe Nurse Staffing. REPORTING
methodSTROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.