Improved work environments and staffing lead to less missed nursing care: A panel study

Area of Science:

• Nursing Research
• Healthcare Management
• Patient Safety

Background:

• Missed nursing care is a critical indicator of diminished healthcare quality, negatively impacting patient experiences and outcomes.
• Existing research, primarily from cross-sectional studies, suggests a link between supportive hospital work environments, adequate nurse staffing, and reduced missed nursing care.
• There is a need for longitudinal evidence to establish causal relationships between these factors.

Purpose of the Study:

• To investigate the association between changes in hospital work environment and nurse staffing over a decade and subsequent alterations in missed nursing care.
• To provide causal evidence on the impact of work environment and staffing on missed nursing care.

Main Methods:

• A longitudinal panel study design was employed.
• Secondary data from 23,650 nurses in 2006 and 14,935 nurses in 2016 were analyzed.
• Data originated from a four-state survey of random samples of licensed nurses across 458 hospitals.

Main Results:

• Over a 10-year period, most hospitals showed improvements in work environments and nurse staffing, alongside an increase in missed nursing care.
• However, in hospitals where work environments or nurse staffing improved, there was a significant decrease in the prevalence and frequency of missed nursing care.
• The impact of improvements in the work environment on reducing missed care was more pronounced than that of increased nurse staffing.

Conclusions:

• Changes in the hospital work environment and nurse staffing levels demonstrably influence the occurrence of missed nursing care.
• Modifying the work environment and staffing are effective strategies for mitigating compromises in patient care.
• Nurse managers should proactively assess hospital work settings to identify and address potential deficiencies.