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Observational study of the relationship between nurse staffing levels and compliance with mandatory nutritional assessments in hospital.

Recio-Saucedo, A., Smith, G. B., Redfern, O., Maruotti, A., Griffiths, P. and Missed Care Study Group, , 2021. Observational study of the relationship between nurse staffing levels and compliance with mandatory nutritional assessments in hospital. Journal of Human Nutrition and Dietetics, 34 (4), 679-686.

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Nurse staffing and nutrition assessment(RevisedSubmission_Preprint for web.pdf - Accepted Version
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DOI: 10.1111/jhn.12847


BACKGROUND: In the UK, it is recommended that hospital patients have their nutritional status assessed within 24 h of admission using the Malnutrition Universal Screening Tool (MUST). The present study aimed to examine the association between nurse staffing levels and missed nutritional status assessments. METHODS: A single-centre, retrospective, observational study was employed using routinely collected MUST assessments from 32 general adult hospital wards over 2 years, matched to ward nurse staffing levels. We used mixed-effects logistic regression to control for ward characteristics and patient factors. RESULTS: Of 43 451 instances where staffing levels could be linked to a patient for whom an assessment was due, 21.4% had no MUST score recorded within 24 h of admission. Missed assessments varied between wards (8-100%). There was no overall association between registered nurse staffing levels and missed assessments; although higher admissions per registered nurse were associated with more missed assessments [odds ratio (OR) = 1.09, P = 0.005]. Higher healthcare assistant staffing was associated with lower rates of missed assessments (OR = 0.80, P < 0.001). There was a significant interaction between registered nurses and healthcare assistants staffing levels (OR = 0.97, P = 0.011). CONCLUSIONS: Despite a written hospital policy requiring a nutritional assessment within 24 h of admission, missed assessments were common. The observed results show that compliance with the policy for routine MUST assessments within 24 h of hospital admission is sensitive to staffing levels and workload. This has implications for planning nurse staffing.

Item Type:Article
Additional Information:Research Funding Health Services and Delivery Research Programme. Grant Number: NIHR HS&DR 13/114/17
Uncontrolled Keywords:hospital care ; missed care ; nursing workforce ; nutrition assessments ; patient outcomes
Group:Faculty of Health & Social Sciences
ID Code:35036
Deposited By: Symplectic RT2
Deposited On:12 Jan 2021 13:16
Last Modified:14 Mar 2022 14:25


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