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Journal Article > Study
Post-operative mortality, missed care and nurse staffing in nine countries: a cross-sectional study.
Ball JE, Bruyneel L, Aiken LH, et al; RN4Cast Consortium. Int J Nurs Stud. 2018;78:10-15.
Missed nursing care may result from inadequate nurse staffing and explain the relationship between nurse-to-patient ratios and patient outcomes. Research has shown that higher nurse staffing levels are associated with lower inpatient mortality and that reduced staffing increases the risk for postoperative complications. In this study, investigators examined data from more than 400,000 surgical patients from 300 hospitals in 9 countries as well as survey responses from 26,516 nurses. They found a significant association between nurse staffing and missed nursing care with 30-day risk-adjusted postoperative mortality. The authors conclude that measuring missed nursing care may help identify patients at greater risk for adverse outcomes earlier in their course. A past WebM&M commentary highlighted important issues associated with nurse staffing ratios.
Journal Article > Commentary
Incorporating nursing complexity in reimbursement coding systems: the potential impact on missed care.
Sasso L, Bagnasco A, Aleo G, et al. BMJ Qual Saf. 2017;26:929-932.
Journal Article > Review
Griffiths P, Recio-Saucedo A, Dall'Ora C, et al; Missed Care Study Group. J Adv Nurs. 2018;74:1474-1487.
Nurse staffing levels, missed vital signs and mortality in hospitals: retrospective longitudinal observational study.
Griffiths P, Ball J, Bloor K, et al. Health Services and Delivery Research. Southampton, UK: NIHR Journals Library; 2018.
Missed nursing care has been linked to safety problems, but ensuring reliable levels of nurse staffing remains challenging. This report provides the results of a 3-year investigation into whether tracking of vital signs by nursing staff could serve as a viable measure for safe patient coverage. The report identified correlations between low staffing, missed vital sign observation, length of stay, and likelihood of mortality. However, record review found no direct relationship between safety and staffing levels. A PSNet perspective examined the relationship between missed nursing care and patient safety.
Journal Article > Study
Griffiths P, Maruotti A, Recio Saucedo A, et al; Missed Care Study Group. BMJ Qual Saf. 2019;28:609-617.
There is a clear link between nurse staffing ratios and patient safety. This study corroborates the finding that lower registered nurse staffing and higher numbers of patients admitted per nurse are associated with increased rates of in-hospital mortality. The results underscore the importance of adequate nursing to ensure safe acute care.