The association between nurse staffing and omissions in nursing care: A systematic review
The association between nurse staffing and omissions in nursing care: A systematic review
Aims: to identify nursing care most frequently missed in acute adult inpatient wards and determine evidence for the association of missed care with nurse staffing.
Background: research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy.
Design: systematic review
Data Sources: we searched the Cochrane Library, CINAHL, Embase and Medline (2006-2016) for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles.
Review Methods: two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data was abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative.
Results: eighteen studies gave subjective reports of missed care. 75% or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care.
Conclusions: low registered nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures is yet to be investigated.
1474-1487
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Recio-Saucedo, Alejandra
d05c4e43-3399-466d-99e0-01403a04b467
Dall'ora, Chiara
4501b172-005c-4fad-86da-2d63978ffdfd
Briggs, Jim
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Maruotti, Antonello
7096256c-fa1b-4cc1-9ca4-1a60cc3ee12e
Meredith, Paul
d0a0e287-ad7f-41cb-9347-94d7a0e957c1
Smith, Gary B.
9713f86e-b7d6-4ccb-a81d-ee6c4e76e4c2
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
23 April 2018
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Recio-Saucedo, Alejandra
d05c4e43-3399-466d-99e0-01403a04b467
Dall'ora, Chiara
4501b172-005c-4fad-86da-2d63978ffdfd
Briggs, Jim
9ed71b2f-ab3b-4122-be12-77861a482e97
Maruotti, Antonello
7096256c-fa1b-4cc1-9ca4-1a60cc3ee12e
Meredith, Paul
d0a0e287-ad7f-41cb-9347-94d7a0e957c1
Smith, Gary B.
9713f86e-b7d6-4ccb-a81d-ee6c4e76e4c2
Ball, Jane
85ac7d7a-b21e-42fd-858b-78d263c559c1
Griffiths, Peter, Recio-Saucedo, Alejandra, Dall'ora, Chiara, Briggs, Jim, Maruotti, Antonello, Meredith, Paul, Smith, Gary B. and Ball, Jane
(2018)
The association between nurse staffing and omissions in nursing care: A systematic review.
Journal of Advanced Nursing, 74 (7), .
(doi:10.1111/jan.13564).
Abstract
Aims: to identify nursing care most frequently missed in acute adult inpatient wards and determine evidence for the association of missed care with nurse staffing.
Background: research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy.
Design: systematic review
Data Sources: we searched the Cochrane Library, CINAHL, Embase and Medline (2006-2016) for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles.
Review Methods: two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data was abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative.
Results: eighteen studies gave subjective reports of missed care. 75% or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care.
Conclusions: low registered nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures is yet to be investigated.
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The association between nurse staffing and omissions in nursing care: a systematic review
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Accepted/In Press date: 30 January 2018
e-pub ahead of print date: 8 March 2018
Published date: 23 April 2018
Identifiers
Local EPrints ID: 418449
URI: http://eprints.soton.ac.uk/id/eprint/418449
ISSN: 0309-2402
PURE UUID: 0cab753b-afb2-44b5-be23-91ff96cbe7bd
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Date deposited: 08 Mar 2018 17:30
Last modified: 16 Mar 2024 04:33
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Contributors
Author:
Jim Briggs
Author:
Antonello Maruotti
Author:
Paul Meredith
Author:
Gary B. Smith
Author:
Jane Ball
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