Missed nursing care is linked to patient satisfaction: a cross-sectional study of US hospitals

BackgroundAs nurses are the principal care provider in the hospital setting, the completion or omission of nursing care is likely to have a sizable impact on the patient care experience. However, this relationship has not been explored empirically.AimTo describe the prevalence and patterns of missed...

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Bibliographic Details
Published in:BMJ quality & safety Vol. 25; no. 7; pp. 535 - 543
Main Authors: Lake, Eileen T, Germack, Hayley D, Viscardi, Molly Kreider
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01.07.2016
Subjects:
Adult
Cross-Sectional Studies
Hospitals
Hospitals - standards
Hospitals - statistics & numerical data
Humans
Medical Errors - statistics & numerical data
Medical personnel
Nurses
Nursing care
Nursing Staff, Hospital - standards
Nursing Staff, Hospital - statistics & numerical data
Patient satisfaction
Patient Satisfaction - statistics & numerical data
United States
Work environment
United States > US
Nurses
Patient satisfaction
Health services research
ISSN:2044-5415, 2044-5423
Online Access:Get full text
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Summary:BackgroundAs nurses are the principal care provider in the hospital setting, the completion or omission of nursing care is likely to have a sizable impact on the patient care experience. However, this relationship has not been explored empirically.AimTo describe the prevalence and patterns of missed nursing care and explore their relationship to the patient care experience.MethodsThis cross-sectional study used secondary nurse and patient survey data from 409 adult non-federal acute care US hospitals in four states. Descriptive statistics were calculated and linear regression models were conducted at the hospital level. Regression models included controls for hospital structural characteristics.ResultsIn an average hospital, nurses missed 2.7 of 12 required care activities per shift. Three-fourths (73.4%) of nurses reported missing at least one activity on their last shift. This percentage ranged from 25 to 100 across hospitals. Nurses most commonly reported not being able to comfort or talk with patients (47.6%) and plan care (38.5%). 6 out of 10 patients rated hospitals highly. This proportion ranged from 33% to 90% across hospitals. At hospitals where nurses missed more care (1 SD higher=0.74 items), 2.2% fewer patients rated the hospital highly (p<0.001); a coefficient equivalent to a one-quarter SD change.ConclusionsMissed nursing care is common in US hospitals and varies widely. Most patients rate their hospital care experience highly, but this also varies widely across hospitals. Patients have poorer care experiences in hospitals where more nurses miss required nursing care. Supporting nurses’ ability to complete required care may optimise the patient care experience. As hospitals face changing reimbursement landscapes, ensuring adequate nursing resources should be a top priority.
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ISSN:2044-5415
2044-5423
DOI:10.1136/bmjqs-2015-003961