• J Adv Nurs · Jul 2018

    Review

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

    • Peter Griffiths, Alejandra Recio-Saucedo, Chiara Dall'Ora, Jim Briggs, Antonello Maruotti, Paul Meredith, Gary B Smith, Jane Ball, and Missed Care Study Group.
    • Faculty of Health Sciences, University of Southampton, Southampton, UK.
    • J Adv Nurs. 2018 Jul 1; 74 (7): 1474-1487.

    AimsTo identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing.BackgroundResearch 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.DesignSystematic review.Data SourcesWe 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 MethodsTwo 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.ResultsEighteen 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.ConclusionsLow 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.© 2018 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

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