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Patient views of care affected by nurse staffing levels and skill mix, study shows

sleeping patient

Source:  Ingimage

Patient-perceived quality of nursing care falls as registered nurse staffing levels in hospital decline, a study has found.

The study involved more than 28,000 patients across 1,017 hospitals in Germany, who stayed at least two nights in hospital.
Published in BMJ Open, the paper contacted patients within eight weeks of being discharged from general hospitals using an online patient survey.
Using a patient-to-nurse (PTN) ratio, which indicates how many patients a nurse has to care for during an average shift, the survey found that an increase in the PTN “significantly decreased” the general quality of perceived nursing care, the patient perception of nursing guidance, and nurse-related patient loyalty to a given hospital.
An increase in the ratio of nursing assistants to the number of nurses – skill mix – also led to a significant decrease across all three measures.
“We found strong evidence that a higher proportion of assistant nurses, which means a lower proportion of professionalisation among nursing staff, is negatively associated with all three dimensions of quality of nursing care,” the study concluded.
Further analysis found that differences in both the PTN and the staffing skill mix were only associated with a change in the measures of patient-perceived quality of nursing care for patients judged to have low case severity.
It also found that an increase in the PTN only decreased perception of general nursing care and nurse-related patient loyalty for patients admitted to hospitals with fewer than 500 beds.
Skill-mix affected general nursing care perceptions and nurse-related patient loyalty in small hospitals only, while it affected the perception of guidance provided by nurses in both small and large hospitals.
The study – titled Nurse staffing and patient-perceived quality of nursing care: a cross-sectional analysis of survey and administrative data in German hospitals – adds to a large body of evidence about safe nurse staffing.

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