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The association between nurse staffing and omissions in nursing care: A systematic review.

Griffiths, P., Recio-Saucedo, A., Dall'Ora, C., Briggs, J., Maruotti, A., Meredith, P., Smith, G. B., Ball, J. and Missed Care Study Group, , 2018. The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74 (7), 1474 - 1487.

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Griffiths_et_al-2018-Journal_of_Advanced_Nursing.pdf - Published Version
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DOI: 10.1111/jan.13564


AIMS: To identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing. BACKGROUND: Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. DESIGN: Systematic review. DATA SOURCES: We searched the Cochrane Library, CINAHL, Embase and Medline for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. REVIEW METHODS: Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. RESULTS: Eighteen studies gave subjective reports of missed care. Seventy-five per cent or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. CONCLUSIONS: Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures, is yet to be investigated.

Item Type:Article
Additional Information:Funding informationThis is independent research funded by the National Institute for Health Research (NIHR) Health Services & Delivery Research programme (Grant number 13/114/17). The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health
Uncontrolled Keywords:care left undone; hospital; implicit rationing; missed care; nursing staff; quality; skill mix; systematic review ; workforce
Group:Faculty of Health & Social Sciences
ID Code:30965
Deposited By: Symplectic RT2
Deposited On:09 Jul 2018 12:56
Last Modified:14 Mar 2022 14:11


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