Observational study of the relationship between nurse staffing levels and compliance with mandatory nutritional assessments in hospital
Observational study of the relationship between nurse staffing levels and compliance with mandatory nutritional assessments in hospital
BACKGROUND: In the UK, it is recommended that hospital patients have their nutritional status assessed within 24 h of admission using the Malnutrition Universal Screening Tool (MUST). The present study aimed to examine the association between nurse staffing levels and missed nutritional status assessments. METHODS: A single-centre, retrospective, observational study was employed using routinely collected MUST assessments from 32 general adult hospital wards over 2 years, matched to ward nurse staffing levels. We used mixed-effects logistic regression to control for ward characteristics and patient factors. RESULTS: Of 43 451 instances where staffing levels could be linked to a patient for whom an assessment was due, 21.4% had no MUST score recorded within 24 h of admission. Missed assessments varied between wards (8-100%). There was no overall association between registered nurse staffing levels and missed assessments; although higher admissions per registered nurse were associated with more missed assessments [odds ratio (OR) = 1.09, P = 0.005]. Higher healthcare assistant staffing was associated with lower rates of missed assessments (OR = 0.80, P < 0.001). There was a significant interaction between registered nurses and healthcare assistants staffing levels (OR = 0.97, P = 0.011). CONCLUSIONS: Despite a written hospital policy requiring a nutritional assessment within 24 h of admission, missed assessments were common. The observed results show that compliance with the policy for routine MUST assessments within 24 h of hospital admission is sensitive to staffing levels and workload. This has implications for planning nurse staffing.
hospital care, missed care, nursing workforce, nutrition assessments, patient outcomes
679-686
Recio Saucedo, Alejandra
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Smith, Gary B.
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Redfern, Oliver
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Maruotti, Antonello
53159118-f31e-4f3e-b812-dff432d74229
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
August 2021
Recio Saucedo, Alejandra
d05c4e43-3399-466d-99e0-01403a04b467
Smith, Gary B.
6a214baf-1020-40a7-96e2-ecd3ad360896
Redfern, Oliver
fbfa43f6-3677-4bbf-a261-09f8baf96e27
Maruotti, Antonello
53159118-f31e-4f3e-b812-dff432d74229
Griffiths, Peter
ac7afec1-7d72-4b83-b016-3a43e245265b
Recio Saucedo, Alejandra, Smith, Gary B., Redfern, Oliver, Maruotti, Antonello and Griffiths, Peter
(2021)
Observational study of the relationship between nurse staffing levels and compliance with mandatory nutritional assessments in hospital.
Journal of Human Nutrition and Dietetics, 34 (4), .
(doi:10.1111/jhn.12847).
Abstract
BACKGROUND: In the UK, it is recommended that hospital patients have their nutritional status assessed within 24 h of admission using the Malnutrition Universal Screening Tool (MUST). The present study aimed to examine the association between nurse staffing levels and missed nutritional status assessments. METHODS: A single-centre, retrospective, observational study was employed using routinely collected MUST assessments from 32 general adult hospital wards over 2 years, matched to ward nurse staffing levels. We used mixed-effects logistic regression to control for ward characteristics and patient factors. RESULTS: Of 43 451 instances where staffing levels could be linked to a patient for whom an assessment was due, 21.4% had no MUST score recorded within 24 h of admission. Missed assessments varied between wards (8-100%). There was no overall association between registered nurse staffing levels and missed assessments; although higher admissions per registered nurse were associated with more missed assessments [odds ratio (OR) = 1.09, P = 0.005]. Higher healthcare assistant staffing was associated with lower rates of missed assessments (OR = 0.80, P < 0.001). There was a significant interaction between registered nurses and healthcare assistants staffing levels (OR = 0.97, P = 0.011). CONCLUSIONS: Despite a written hospital policy requiring a nutritional assessment within 24 h of admission, missed assessments were common. The observed results show that compliance with the policy for routine MUST assessments within 24 h of hospital admission is sensitive to staffing levels and workload. This has implications for planning nurse staffing.
Text
Observational study of the relationship between nurse staffing levels and compliance with mandatory nutritional assessments in hospital
- Accepted Manuscript
More information
Accepted/In Press date: 30 October 2020
e-pub ahead of print date: 6 January 2021
Published date: August 2021
Keywords:
hospital care, missed care, nursing workforce, nutrition assessments, patient outcomes
Identifiers
Local EPrints ID: 445223
URI: http://eprints.soton.ac.uk/id/eprint/445223
ISSN: 0952-3871
PURE UUID: 323d2fcf-1930-41f6-b7f4-628ffc63c174
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Date deposited: 25 Nov 2020 17:32
Last modified: 17 Mar 2024 06:05
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Contributors
Author:
Gary B. Smith
Author:
Oliver Redfern
Author:
Antonello Maruotti
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