Nurses ; Nursing care ; Quality indicators ; Health care ; Working conditions
Abstract
Purpose
This scoping review aimed to identify nursing-sensitive indicators in East Asian hospitals and understand their relationships.
Methods
We followed the Joanna Briggs Institute guidelines and conducted searches across 12 databases, including gray literature sources, such as ProQuest Dissertations and Theses Global, based on specific inclusion and exclusion criteria.
Results
Of the 5,887 articles identified, we included 46 studies that met the inclusion criteria. Overall, we identified 72 nursing-sensitive indicators, which were classified into three distinct categories; –structure, process, and outcome, aligned with Donabedian’s structure-process-outcome model. Our findings revealed that nurse staffing levels and patient mortality were the most frequently reported nursing-sensitive indicators in East Asian hospitals. Additionally, we found that nurse staffing levels and work environment were significantly associated with improved outcomes for patients and nurses. Several nursing-sensitive indicators, such as turnover intention and caregiver self-efficacy, were derived only in this review. Some nursing-sensitive indicators, such as nurse staffing levels and patient mortality, had limitations because their definitions and measurement methods varied across studies.
Conclusion
This study provides a comprehensive overview of nursing-sensitive indicators in East Asian hospitals. Adequate nurse staffing levels and positive work environment are important in achieving positive patient and nurse outcomes; therefore, hospital administrators should make efforts to improve them. Further consideration is required to determine whether nursing-sensitive indicators derived only from East Asian countries are appropriate for use in this study. Inconsistencies in the operational definitions and measurement methods of nursing-sensitive indicators hinder evidence generation through the synthesis of research findings. Therefore, nursing researchers should standardize nursing-sensitive indicators in this specific healthcare context.