Acuity, nurse staffing and workforce, missed care and patient outcomes. A cluster-unit-level descriptive comparison

Aim: To compare 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 desi...

Descripción completa

Detalles Bibliográficos
Autores: Juvé Udina, Eulàlia, González Samartino, Maribel, López Jiménez, María Magdalena, Planas Canals, Maria, Rodríguez Fernández, Hugo, Batuecas Duelt, Irene Joana, Tapia Pérez, Marta, Pons Prat, Mònica, Jiménez Martínez, Emilio, Barberà Llorca, Miquel Àngel, Asensio Flores, Susana, Berbis Morelló, Carme, Zuriguel Pérez, Esperanza, Delgado-Hito, Pilar, Rey Luque, Óscar, Zabalegui Yárnoz, Adelaida, Fabrellas i Padrès, Núria, Adamuz, Jordi
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:2445/173010
Acceso en línea:https://hdl.handle.net/2445/173010
Access Level:acceso abierto
Palabra clave:Serveis d'infermeria
Seguretat dels pacients
Nursing services
Patients safety
Descripción
Sumario:Aim: To compare 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 stepdown 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, whilst nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unitclusters, 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 policy-makers to address structural understaffing in general wards, to maximize patient safety outcomes.