What explains nurses' perceptions of staffing adequacy?

Much attention is being paid to the adequacy of nurse staffing in acute care hospitals, and much of the information relies on nurses' perceptions about staffing adequacy. Yet, we know little about what influences these perceptions.

We examined the impact of hospital characteristics, nursing unit characteristics, nurse characteristics, and patient characteristics on nurses' perceptions of staffing adequacy. We tested three different models, incorporating different conceptualizations that relate current and past characteristics to these perceptions.

This was a secondary analysis of data from the Outcomes Research in Nursing Administration Project, a longitudinal study conducted in 60 hospitals in the Southeastern United States.

Perceptions of staffing adequacy were influenced significantly by the hospital's case mix index and growth in hospital admissions, by the number of beds on a unit, and by patient acuity. Further, current perceptions of staffing adequacy were significantly affected by prior perceptions.

Based on our results, we present potential interventions for administrators that may ameliorate some of the negative influences on nurses' perceptions of staffing adequacy.