Improved work environments and staffing lead to less missed nursing care: A panel study

Aim To document how changes in the hospital work environment and nurse staffing over time are associated with changes in missed nursing care. Background Missed nursing care is considered an indicator of poorer care quality and has been associated with worse patient care experiences and health outcom...

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Published in:Journal of nursing management Vol. 28; no. 8; pp. 2157 - 2165
Main Authors: Lake, Eileen T., Riman, Kathryn A., Sloane, Douglas M.
Format: Journal Article
Language:English
Published: England John Wiley & Sons, Inc 01.11.2020
Subjects:
Change agents
Changes
Clinical outcomes
Cross-Sectional Studies
Health services
Health status
Hospitals
Humans
Longitudinal studies
Medical errors
Medical personnel
missed nursing care
Nurse managers
nurse staffing
Nurses
Nursing
Nursing administration
Nursing Care
Nursing Staff, Hospital
Patients
Personnel Staffing and Scheduling
Polls & surveys
Quality of care
Quality of Health Care
Ratios
Staffing
Systematic review
Work environment
Workforce
Workforce planning
missed nursing care
work environment
nurse staffing
ISSN:0966-0429, 1365-2834, 1365-2834
Online Access:Get full text
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Summary:Aim To document how changes in the hospital work environment and nurse staffing over time are associated with changes in missed nursing care. Background Missed nursing care is considered an indicator of poorer care quality and has been associated with worse patient care experiences and health outcomes. Several systematic reviews of cross‐sectional studies report that nurses in hospitals with supportive work environments and higher staffing miss less care. Causal evidence demonstrating these relationships is needed. Methods This panel study utilized secondary data from 23,650 nurses surveyed in 2006 and 14,935 surveyed in 2016 in 458 hospitals from a four‐state survey of random samples of licensed nurses. Results Over the 10‐year period, most hospitals exhibited improved work environments, better nurse staffing and more missed care. In hospitals with improved work environments or nurse staffing, the prevalence and frequency of missed care decreased significantly. The effect on missed care of changes in the work environment was greater than that of nurse staffing. Conclusions Changes in the hospital work environment and staffing influence missed care. Implications for Nursing Management Modifications in the work environment and staffing are strategies to mitigate care compromise. Nurse managers should investigate work settings in order to identify weaknesses.
Bibliography:Funding information
This study was supported by grants from the National Institute of Nursing Research (T32‐NR‐007104 and R01‐NR‐014855, to L.H. Aiken, principal investigator). Equipment is not applicable to this project.
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ISSN:0966-0429
1365-2834
1365-2834
DOI:10.1111/jonm.12970