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J Nurs Scholarsh. 2017 May;49(3):347-355. doi: 10.1111/jnu.12292. Epub 2017 Apr 7.

Relationships Between Nurse Staffing and Patients' Experiences, and the Mediating Effects of Missed Nursing Care.

Author information

1
Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, South Korea.
2
Sarah Frances Russell Distinguished Professor, School of Nursing, University of North Carolina, Chapel Hill, NC, USA.
3
Professor, School of Nursing, University of North Carolina, Chapel Hill, NC, USA.
4
Doctoral Student, College of Nursing, Seoul National University, Seoul, South Korea.

Abstract

PURPOSE:

The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences.

DESIGN:

The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea.

METHODS:

Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy. Patients' experiences included adverse events, communication with nurses, and overall hospital rating. Patient-reported missed care was measured using the MISSCARE Survey-Patient with three domains: communication, basic care, and timely response.

FINDINGS:

Lower nurse-perceived staffing adequacy was associated with more patient-reported missed communication. Lower patient-perceived staffing adequacy was associated with more missed care and adverse events, and a lower likelihood of experiencing good communication with nurses and of giving a high overall rating to the hospital. Patient-reported missed care mediated the relationship between nurse staffing and patients' experiences.

CONCLUSIONS:

Nurse staffing adequacy, particularly as perceived by patients, was significantly associated with patient-reported missed communication and basic care, as well as patients' experiences.

CLINICAL RELEVANCE:

Appropriate nurse staffing is required to reduce missed care and to improve patients' experiences.

KEYWORDS:

Adverse events; missed nursing care; nurse staffing; patients' experience

PMID:
28388827
DOI:
10.1111/jnu.12292
[Indexed for MEDLINE]

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