Relationships Between Nurse Staffing and Patients' Experiences, and the Mediating Effects of Missed Nursing Care

The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences.

The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea.

Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy. Patients' experiences included adverse events, communication with nurses, and overall hospital rating. Patient-reported missed care was measured using the MISSCARE Survey-Patient with three domains: communication, basic care, and timely response.

Lower nurse-perceived staffing adequacy was associated with more patient-reported missed communication. Lower patient-perceived staffing adequacy was associated with more missed care and adverse events, and a lower likelihood of experiencing good communication with nurses and of giving a high overall rating to the hospital. Patient-reported missed care mediated the relationship between nurse staffing and patients' experiences.

Nurse staffing adequacy, particularly as perceived by patients, was significantly associated with patient-reported missed communication and basic care, as well as patients' experiences.

Appropriate nurse staffing is required to reduce missed care and to improve patients' experiences.