ArticleJournal of nursing management2020
Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster-unit-level descriptive comparison.
Article in Journal of nursing management, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Quiet Quitting and Associated Factors Among Healthcare Professionals: A Systematic Review and Meta-Analysis.Journal of nursing management · 2026Pooled it
- Informal Digital Coordination of Nurse Shift Swaps in a Saudi Tertiary Hospital: A Qualitative Descriptive Study.Healthcare (Basel, Switzerland) · 2026Article
- Understanding communication challenges in nursing care of patients with limited health literacy: a qualitative study.BMC nursing · 2026Article
- Understanding missed nursing care through felt accountability focus and task complexity: A prospective repeated-measures field study.International journal of nursing studies advances · 2026Article
- A Systematic Review of Stress-Related Work and Missed Nursing Care Among Clinical Nurses.Healthcare (Basel, Switzerland) · 2026Review
- Prevalence and Predictors of Missed Nursing Care in Greek Public Hospitals: A National Cross-Sectional Study.Journal of nursing management · 2026Article
- Associations of safe nurse staffing coverage and care complexity factors with nursing-sensitive adverse events in cardiac inpatients: a cross-sectional multicenter study.Frontiers in cardiovascular medicine · 2026Article
- Article
- Proactive huddles to reduce missed nursing care; the mediating roles of personal situational awareness and rational coordination: A cluster randomized pre post intervention study.International journal of nursing studies advances · 2025Article
- Exploring the Relation Between Nursing Workload and Moral Distress, Burnout, and Turnover in Latvian Intensive Care Units: An Ecological Analysis of Parallel Data.International journal of environmental research and public health · 2025Article
- Observational
- Impact of nurse staffing coverage and care complexity factors on health outcomes in hospitalized COVID-19 patients: a cross-sectional study.BMC nursing · 2025Article
- Changing the Organizational Structure and Enhancing Nurse-Staffing Levels Based on Patient Acuity in a Tertiary Referral Hospital.Journal of nursing management · 2025Article
- Article
- Observational
- Inadequate number of staff and other reasons for implicit rationing of nursing care across hospital types and units.Nursing open · 2023Article
- The Effects of COVID-19 Pandemic Policy on Social Needs Across the State of Kansas and Western Missouri: Paired Survey Response Testing.JMIR public health and surveillance · 2023Article
- Cardiovascular Nursing Workforce Challenges: Transforming the Model of Care for the Future.Methodist DeBakey cardiovascular journal · 2023Review
- The Effects of COVID-19 Pandemic on Trauma Registry and Performance Improvement Operations and Workforce Nationwide: A Survey of Trauma Center Association of America Members.The Journal of surgical research · 2022Article
- Emergency Nursing Countermeasures and Experience of Patients with Primary Liver Cancer Nodule Rupture and Hemorrhage.Emergency medicine international · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors at 9 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimTo compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit-clusters.
backgroundRelationships among acuity, nurse staffing and workforce, missed nursing care and patient outcomes are not completely understood.
methodDescriptive design with data from four unit-clusters: medical, surgical, combined and step-down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse-sensitive outcomes.
resultsPatient 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.
conclusionPatient acuity is similar among unit-clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit-clusters, 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 policymakers to address structural understaffing in general wards, to maximize patient safety outcomes.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.