Effects of increasing nurse staffing on missed nursing care

Cho, S.-H.; Kim, Y.-S.; Yeon, Kyupil; You, Sun-Ju; Lee, I.D.

doi:10.1111/inr.12173

Cited by 126 publications

(162 citation statements)

References 18 publications

Supporting

Mentioning

130

Contrasting

Unclassified

Order By: Relevance

“…Those six least missed activities are exactly the same as those identified in a Korean study that compared missed care in highstaffing and low-staffing nursing units (Cho et al, 2015). Those six least missed activities are exactly the same as those identified in a Korean study that compared missed care in highstaffing and low-staffing nursing units (Cho et al, 2015).…”

Section: Extensive Family Involvement In Inpatient Care As In Korea Andsupporting

confidence: 66%

Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes

Cho

Lee

You

et al. 2019

Int J of Nursing Practice

153

148

View full text Add to dashboard Cite

Aim:To examine the relationships among nurse staffing, nurses prioritization of nursing activities, missed care, quality of nursing care, and nurse outcomes.Background: Inadequate staffing is associated with increased missed care, which threatens the quality of care and nurse outcomes. Methods:The study sample included 2114 staff nurses from 156 medical or surgical units of 49 general hospitals who had participated in a cross-sectional survey conducted in 2015. Nurse staffing was measured using the patient-to-nurse ratio and perceived staffing adequacy. The Missed Nursing Care Survey was used to measure how frequently nurses had missed each of 24 activities. Multilevel regression analyses were employed to examine the relationships among variables. Results:The prevalence of missed care differed by nursing activity. Poorer staffing was associated with an increased number of missed activities. A higher number of missed activities and poorer staffing were associated with poorer patient safety, quality of nursing care and job satisfaction, and a higher intent to leave. Nurses gave the highest priority to focused patient reassessments, timely medications, and patient teaching, under hypothetical conditions of improved staffing. Conclusion:Adequate staffing is required to reduce missed care and to improve quality of care and nurse outcomes. K E Y W O R D SJob satisfaction, missed nursing care, nurse staffing, quality, safety SUMMARY STATEMENTWhat is already known about this topic?• Low nurse staffing is associated with a high prevalence of missed care, which has negative effects on patient and nurse outcomes.• Nurses are known to prioritize their nursing tasks in the face of time scarcity. However, insufficient studies have investigated how nurses prioritize nursing care and, further, how their prioritization would be modified if nurse staffing were to improve.What is already known about this topic?• Poorer perceptions of staffing adequacy and the patient-to-RN ratio had a significant association with a higher number of missed nursing activities.

show abstract

Section: Extensive Family Involvement In Inpatient Care As In Korea Andsupporting

confidence: 66%

Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes

Cho

Lee

You

et al. 2019

Int J of Nursing Practice

153

148

View full text Add to dashboard Cite

show abstract

“…Patient outcomes reported in the missed care literature, which have been associated with quality of care delivered, include hospital‐acquired infections, discharge planning, mortality, falls, patient mobilisation, feeding, psychological and emotional support (Cho, Kim, Yeon, You, & Lee, 2015; Kalisch, 2006; Kalisch, Tschannen, & Lee, 2011, 2012; Papastavrou, Andreou, & Efstathiou, 2014; Schubert, Clarke, Aiken, & de Geest, 2012). Likely factors that influence care prioritisation and completion include the time that is required to complete a care task and the immediate effect that delaying or missing this task might have on patients (Kalisch, 2006).…”

Section: Introductionmentioning

confidence: 99%

What impact does nursing care left undone have on patient outcomes? Review of the literature

Recio‐Saucedo

Dall’Ora

Maruotti

et al. 2017

Journal of Clinical Nursing

329

304

View full text Add to dashboard Cite

Aims and objectivesSystematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes.BackgroundA considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear.DesignSystematic review.MethodsWe searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review.ResultsFourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged.ConclusionsThe review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self‐reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required.Relevance to clinical practiceAlthough nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.

show abstract

“…The new demands in these areas require the constant reevaluation of the size and qualifi cations of nursing staff to ensure the quality and safety of interventions (1) . A growing body of evidence has pointed to an association between the adequacy of the nursing staff and the quality of patient care (2)(3)(4) . Therefore, the assessment of nursing workload in distinct units of diff erent types of patients has become a crucial method of assessing these individuals' actual treatment needs.…”

Section: Introductionmentioning

confidence: 99%

Nursing workload in a coronary unit according to the Nursing Activities Score

Reich

Vieira

Lima

et al. 2015

Rev. Gaúcha Enferm.

View full text Add to dashboard Cite

Objective: this study aimed to using the Nursing Activities Score to assess nursing workload in a coronary care unit, to assess the distribution of workload between shifts, and to compare the current staff of the care unit with that recommended by the instrument.Method: this was a longitudinal study, conducted in a teaching hospital in Southern Brazil, between April to June 2012.Results: A total of 604 NAS measures were obtained from the 61 patients included. The mean workload per shift was 47% (±12), with the greatest workload being reported in the afternoon shifts.Conclusion: according to the NAS, a mean of two and a maximum of 2.4 nursing professionals would be required per shift to meet all patient demands, suggesting that the current staff size in the CCU is adequate. The NAS was successful in assessing nursing workload and changes in patient demands over time.

show abstract

Effects of increasing nurse staffing on missed nursing care

Abstract: Adequate nurse staffing should be ensured to reduce unmet nursing needs and improve patient outcomes.

Cited by 126 publications

References 18 publications

Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes

Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes

What impact does nursing care left undone have on patient outcomes? Review of the literature

Nursing workload in a coronary unit according to the Nursing Activities Score

Contact Info

Product

Resources

About