Patient Reports of Nursing Care and the Relationship to Nurse Staffing.

Missed Nursing Care;Nurse Staffing;Patient Reports;Nursing;Health Sciences;Nursing

Dabney, Beverly WallerTzeng, Huey-Ming ;

University of Michigan

关键词: Missed Nursing Care;    Nurse Staffing;    Patient Reports;    Nursing;    Health Sciences;    Nursing;   

Others  :  https://deepblue.lib.umich.edu/bitstream/handle/2027.42/97879/bevw_3.pdf?sequence=3&isAllowed=y

瑞士|英语

来源: The Illinois Digital Environment for Access to Learning and Scholarship

【 摘 要 】

Missed nursing care is defined as any aspect of required patient care that is omitted or delayed. Previous studies of missed nursing care, as reported by nursing staff, have found evidence that inpatient unit nurse staffing levels affect the amount of missed nursing care. This study evaluated patient reports of missed nursing care (measured as missed communication, missed basic care, and missed timeliness) and relationships between missed nursing care and three inpatient unit nurse staffing measures: Registered nurse hours of care per patient day (RNHPPD), all nursing staff hours of care per patient day (NHPPD), and registered nurse (RN) skill mix. Additionally, patient related and unit related characteristics contributing to reports of missed nursing care were examined as covariates. METHODS: A secondary data analysis was conducted using survey data from 729 adult patients from 20 inpatient units in 2 acute care hospitals in the Midwest region of the United States, as well as hospital administrative data. RESULTS: Patients reported mouth care and mobilization to be the elements of nursing care most frequently omitted.The nurse staffing variables were correlated with missed timeliness but not missed communication or basic care.The timeliness of nursing care was found to be negatively associated with RNHPPD (r = -.14, p = <.001), NHPPD (r = -.09, p = .015), and RN Skill Mix (r = -.13, p = .0004). That is, as each of the staffing variable levels increased, reports of missed timeliness decreased. Hierarchical linear modeling found RN Skill Mix to be a predictor of patient reported missed timeliness (p = .01). Additionally, patients who were younger, had poorer health, and who had a history of a psychiatric diagnosis reported more missed timeliness. The nurse staffing variables were not found to be predictors of patient reported missed communication or basic care. CONCLUSIONS: The results of this study suggest that the level of nurse staffing impacts the timeliness of nursing care.Having higher ratios of registered nurses to other nursing staff was particularly important, resulting in patients receiving their care more quickly.