Volume 28, Issue 8 pp. 2157-2165

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

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Eileen T. Lake PhD, RN, FAAN,

Corresponding Author

Eileen T. Lake PhD, RN, FAAN

Professor

[email protected]

orcid.org/0000-0002-8823-3436

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

Correspondence

Eileen T. Lake, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA.

Email: [email protected]

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Kathryn A. Riman BSPH, BS, RN,

Kathryn A. Riman BSPH, BS, RN

Predoctoral Research Fellow

orcid.org/0000-0002-9687-1630

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Douglas M. Sloane PhD,

Douglas M. Sloane PhD

Research Professor

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Eileen T. Lake PhD, RN, FAAN,

Corresponding Author

Eileen T. Lake PhD, RN, FAAN

Professor

[email protected]

orcid.org/0000-0002-8823-3436

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

Correspondence

Eileen T. Lake, Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA.

Email: [email protected]

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Kathryn A. Riman BSPH, BS, RN,

Kathryn A. Riman BSPH, BS, RN

Predoctoral Research Fellow

orcid.org/0000-0002-9687-1630

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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Douglas M. Sloane PhD,

Douglas M. Sloane PhD

Research Professor

Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania

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First published: 03 February 2020

https://doi.org/10.1111/jonm.12970

Citations: 90

Funding information

This study was supported by grants from the National Institute of Nursing Research (T32-NR-007104 and R01-NR-014855, to L.H. Aiken, principal investigator). Equipment is not applicable to this project.

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Abstract

Aim

To document how changes in the hospital work environment and nurse staffing over time are associated with changes in missed nursing care.

Background

Missed nursing care is considered an indicator of poorer care quality and has been associated with worse patient care experiences and health outcomes. Several systematic reviews of cross-sectional studies report that nurses in hospitals with supportive work environments and higher staffing miss less care. Causal evidence demonstrating these relationships is needed.

Methods

This panel study utilized secondary data from 23,650 nurses surveyed in 2006 and 14,935 surveyed in 2016 in 458 hospitals from a four-state survey of random samples of licensed nurses.

Results

Over the 10-year period, most hospitals exhibited improved work environments, better nurse staffing and more missed care. In hospitals with improved work environments or nurse staffing, the prevalence and frequency of missed care decreased significantly. The effect on missed care of changes in the work environment was greater than that of nurse staffing.

Conclusions

Changes in the hospital work environment and staffing influence missed care.

Implications for Nursing Management

Modifications in the work environment and staffing are strategies to mitigate care compromise. Nurse managers should investigate work settings in order to identify weaknesses.

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

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Abstract

Aim

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Conclusions

Implications for Nursing Management

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References

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

Correction(s) for this article

Corrigendum

Abstract

Aim

Background

Methods

Results

Conclusions

Implications for Nursing Management

REFERENCES

Citing Literature

References

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