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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Vydáno v:	BMJ quality & safety Ročník 25; číslo 7; s. 535 - 543
Hlavní autoři:	Lake, Eileen T, Germack, Hayley D, Viscardi, Molly Kreider
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England BMJ Publishing Group LTD 01.07.2016
Témata:	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
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Abstract	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.
AbstractList	Background As 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. Aim To describe the prevalence and patterns of missed nursing care and explore their relationship to the patient care experience. Methods This 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. Results In 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. Conclusions Missed 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. 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. As 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. To describe the prevalence and patterns of missed nursing care and explore their relationship to the patient care experience. This 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. In 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. Missed 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. Background As 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. Aim To describe the prevalence and patterns of missed nursing care and explore their relationship to the patient care experience. Methods This 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. Results In 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.Conclusions Missed 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. References
Author	Viscardi, Molly Kreider Germack, Hayley D Lake, Eileen T
AuthorAffiliation	1 Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA 2 McKinsey & Company, Philadelphia, Pennsylvania, USA
AuthorAffiliation_xml	– name: 2 McKinsey & Company, Philadelphia, Pennsylvania, USA – name: 1 Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA
Author_xml	– sequence: 1 givenname: Eileen T surname: Lake fullname: Lake, Eileen T email: elake@nursing.upenn.edu organization: Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA – sequence: 2 givenname: Hayley D orcidid: 0000-0003-0924-4581 surname: Germack fullname: Germack, Hayley D email: elake@nursing.upenn.edu organization: Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, Pennsylvania, USA – sequence: 3 givenname: Molly Kreider surname: Viscardi fullname: Viscardi, Molly Kreider email: elake@nursing.upenn.edu organization: McKinsey & Company, Philadelphia, Pennsylvania, USA
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/26376673$$D View this record in MEDLINE/PubMed
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Copyright	Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing Copyright: 2016 Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing
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2014 Feb;23(2):116-25
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Snippet	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... As 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... Background As 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... 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...
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SubjectTerms	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
Title	Missed nursing care is linked to patient satisfaction: a cross-sectional study of US hospitals
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