Acuity, nurse staffing and workforce, missed care and patient outcomes : A cluster-unit-level descriptive comparison
© 2020 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd..
AIM: To compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit-clusters.
BACKGROUND: Relationships among acuity, nurse staffing and workforce, missed nursing care and patient outcomes are not completely understood.
METHOD: Descriptive design with data from four unit-clusters: medical, surgical, combined and step-down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse-sensitive outcomes.
RESULTS: Patient acuity in general (medical, surgical and combined) floors is similar to step-down units, with an average of 5.6 required RN hours per patient day. In general wards, available RN hours per patient day reach only 50% of required RN hours to meet patient needs. Workforce measures are comparable among unit-clusters, and average missed nursing care is 21%. Patient outcomes vary among unit-clusters.
CONCLUSION: Patient acuity is similar among unit-clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit-clusters, mortality, skin injuries and risk of family compassion fatigue rates are higher in general wards.
IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers play a pivotal role in hustling policymakers to address structural understaffing in general wards, to maximize patient safety outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Journal of nursing management - 28(2020), 8 vom: 20. Nov., Seite 2216-2229 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Juvé-Udina, Maria-Eulàlia [VerfasserIn] |
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| Links: |
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| Themen: |
Acuity |
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| Anmerkungen: |
Date Completed 28.07.2021 Date Revised 28.07.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/jonm.13040 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM309674549 |
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| 245 | 1 | 0 | |a Acuity, nurse staffing and workforce, missed care and patient outcomes |b A cluster-unit-level descriptive comparison |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 28.07.2021 | ||
| 500 | |a Date Revised 28.07.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2020 The Authors. Journal of Nursing Management published by John Wiley & Sons Ltd. | ||
| 520 | |a AIM: To compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit-clusters | ||
| 520 | |a BACKGROUND: Relationships among acuity, nurse staffing and workforce, missed nursing care and patient outcomes are not completely understood | ||
| 520 | |a METHOD: Descriptive design with data from four unit-clusters: medical, surgical, combined and step-down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse-sensitive outcomes | ||
| 520 | |a RESULTS: Patient acuity in general (medical, surgical and combined) floors is similar to step-down units, with an average of 5.6 required RN hours per patient day. In general wards, available RN hours per patient day reach only 50% of required RN hours to meet patient needs. Workforce measures are comparable among unit-clusters, and average missed nursing care is 21%. Patient outcomes vary among unit-clusters | ||
| 520 | |a CONCLUSION: Patient acuity is similar among unit-clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit-clusters, mortality, skin injuries and risk of family compassion fatigue rates are higher in general wards | ||
| 520 | |a IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers play a pivotal role in hustling policymakers to address structural understaffing in general wards, to maximize patient safety outcomes | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a acuity | |
| 650 | 4 | |a missed nursing care | |
| 650 | 4 | |a patient outcomes | |
| 650 | 4 | |a patient safety | |
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| 700 | 1 | |a Planas-Canals, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Rodríguez-Fernández, Hugo |e verfasserin |4 aut | |
| 700 | 1 | |a Batuecas Duelt, Irene Joana |e verfasserin |4 aut | |
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