Nurse staffing, nurses prioritization, missed care, quality of nursing care, and nurse outcomes.

Aim: To examine the relationships among nurse staffing, nurses prioritization of nursing activities, missed care, quality of nursing care, and nurse outcomes. Background: Inadequate staffing is associated with increased missed care, which threatens the quality of care and nurse outcomes. Methods: The study sample included 2114 staff nurses from 156 medical or surgical units of 49 general hospitals who had participated in a cross‐sectional survey conducted in 2015. Nurse staffing was measured using the patient‐to‐nurse ratio and perceived staffing adequacy. The Missed Nursing Care Survey was used to measure how frequently nurses had missed each of 24 activities. Multilevel regression analyses were employed to examine the relationships among variables. Results: The prevalence of missed care differed by nursing activity. Poorer staffing was associated with an increased number of missed activities. A higher number of missed activities and poorer staffing were associated with poorer patient safety, quality of nursing care and job satisfaction, and a higher intent to leave. Nurses gave the highest priority to focused patient reassessments, timely medications, and patient teaching, under hypothetical conditions of improved staffing. Conclusion: Adequate staffing is required to reduce missed care and to improve quality of care and nurse outcomes. SUMMARY STATEMENT: What is already known about this topic? Low nurse staffing is associated with a high prevalence of missed care, which has negative effects on patient and nurse outcomes.Nurses are known to prioritize their nursing tasks in the face of time scarcity. However, insufficient studies have investigated how nurses prioritize nursing care and, further, how their prioritization would be modified if nurse staffing were to improve. What is already known about this topic? Poorer perceptions of staffing adequacy and the patient‐to‐RN ratio had a significant association with a higher number of missed nursing activities.Nurses gave the highest priority to focused reassessments, timely medications, and patient teaching, which were less frequently missed than basic care (eg, mouth care, bathing, and ambulation), even under hypothetical conditions of improved staffing. The implications of this paper: Adequate staffing is required to meet patients needs and to improve patient and nurse outcomes.Nurses perceptions and reports of missed care appear to be influenced by their health care system and culture (eg, family caregiving). [ABSTRACT FROM AUTHOR]