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Patient satisfaction with hospital care and nurses in England: an observational study

Patient satisfaction with hospital care and nurses in England: an observational study
Patient satisfaction with hospital care and nurses in England: an observational study
Objectives To inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments.

Design Cross-sectional surveys of 66 348 hospital patients and 2963 inpatient nurses. Setting Patients surveyed were discharged in 2010 from 161 National Health Service (NHS) trusts in England. Inpatient nurses were surveyed in 2010 in a sample of 46 hospitals in 31 of the same 161 trusts.

Participants The 2010 NHS Survey of Inpatients obtained information from 50% of all patients discharged between June and August. The 2010 RN4CAST England Nurse Survey gathered information from inpatient medical and surgical nurses.

Main outcome measures Patient ratings of their hospital care, their confidence in nurses and doctors and other indicators of their satisfaction. Missed nursing care was treated as both an outcome measure and explanatory factor.

Results Patients' perceptions of care are significantly eroded by lack of confidence in either nurses or doctors, and by increases in missed nursing care. The average number of types of missed care was negatively related to six of the eight outcomes - ORs ranged from 0.78 (95% CI 0.68 to 0.90) for excellent care ratings to 0.86 (95% CI 0.77 to 0.95) for medications completely explained - positively associated with higher patient-to-nurse ratios (b=0.15, 95% CI 0.10 to 0.19), and negatively associated with better work environments (b='0.26, 95% CI '0.48 to '0.04).

Conclusions Patients' perceptions of hospital care are strongly associated with missed nursing care, which in turn is related to poor professional nurse (RN) staffing and poor hospital work environments. Improving RN staffing in NHS hospitals holds promise for enhancing patient satisfaction.
2044-6055
Aiken, Linda
c65194c2-956b-4ec2-8e18-862b3a7a35c4
Sloane, Douglas M.
10494ba7-bfc5-48db-996e-6773a265864a
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Bruyneel, Luke
a392ab0a-1b35-41bc-b8d3-b155268ae8da
Rafferty, Anne Marie
d82c2661-2b39-447c-b975-c42834480975
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Aiken, Linda
c65194c2-956b-4ec2-8e18-862b3a7a35c4
Sloane, Douglas M.
10494ba7-bfc5-48db-996e-6773a265864a
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Bruyneel, Luke
a392ab0a-1b35-41bc-b8d3-b155268ae8da
Rafferty, Anne Marie
d82c2661-2b39-447c-b975-c42834480975
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b

Aiken, Linda, Sloane, Douglas M., Ball, Jane, Bruyneel, Luke, Rafferty, Anne Marie and Griffiths, Peter (2018) Patient satisfaction with hospital care and nurses in England: an observational study. BMJ Open, 8 (1). (doi:10.1136/bmjopen-2017-019189).

Record type: Article

Abstract

Objectives To inform healthcare workforce policy decisions by showing how patient perceptions of hospital care are associated with confidence in nurses and doctors, nurse staffing levels and hospital work environments.

Design Cross-sectional surveys of 66 348 hospital patients and 2963 inpatient nurses. Setting Patients surveyed were discharged in 2010 from 161 National Health Service (NHS) trusts in England. Inpatient nurses were surveyed in 2010 in a sample of 46 hospitals in 31 of the same 161 trusts.

Participants The 2010 NHS Survey of Inpatients obtained information from 50% of all patients discharged between June and August. The 2010 RN4CAST England Nurse Survey gathered information from inpatient medical and surgical nurses.

Main outcome measures Patient ratings of their hospital care, their confidence in nurses and doctors and other indicators of their satisfaction. Missed nursing care was treated as both an outcome measure and explanatory factor.

Results Patients' perceptions of care are significantly eroded by lack of confidence in either nurses or doctors, and by increases in missed nursing care. The average number of types of missed care was negatively related to six of the eight outcomes - ORs ranged from 0.78 (95% CI 0.68 to 0.90) for excellent care ratings to 0.86 (95% CI 0.77 to 0.95) for medications completely explained - positively associated with higher patient-to-nurse ratios (b=0.15, 95% CI 0.10 to 0.19), and negatively associated with better work environments (b='0.26, 95% CI '0.48 to '0.04).

Conclusions Patients' perceptions of hospital care are strongly associated with missed nursing care, which in turn is related to poor professional nurse (RN) staffing and poor hospital work environments. Improving RN staffing in NHS hospitals holds promise for enhancing patient satisfaction.

Text Patient Satisfaction with Hospital Care and Nurses in England: An Observational Study - Accepted Manuscript
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Accepted/In Press date: 13 September 2017
e-pub ahead of print date: 11 January 2018

Identifiers

Local EPrints ID: 414802
URI: https://eprints.soton.ac.uk/id/eprint/414802
ISSN: 2044-6055
PURE UUID: 04e8fb00-369f-4554-97e7-0d77c37a1b9e
ORCID for Jane Ball: ORCID iD orcid.org/0000-0002-8655-2994
ORCID for Peter Griffiths: ORCID iD orcid.org/0000-0003-2439-2857

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Date deposited: 11 Oct 2017 16:31
Last modified: 10 Apr 2018 04:01

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Contributors

Author: Linda Aiken
Author: Douglas M. Sloane
Author: Jane Ball ORCID iD
Author: Luke Bruyneel
Author: Anne Marie Rafferty
Author: Peter Griffiths ORCID iD

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