Nurse staffing and patient perceptions of nursing care.
OBJECTIVE To examine the relationship between nurse staffing and patient perceptions of nursing care in a convenience sample of 40 California hospitals.


BACKGROUND
Growing concern about the adequacy of nurse staffing has led to an increased emphasis on research exploring the relationships between nurse staffing and patient outcomes. Patient satisfaction with nursing care is one of the 21 indicators identified by the American Nurses Association as having a strong "theoretical link to the availability and quality of professional nursing services in hospital settings." This prospective study examined the relationship between nurse staffing and patient perceptions of nursing care in multiple hospitals using common definitions of both nurse staffing and patient perceptions of care.


METHODS
Nurse staffing (structural variables) and patient perceptions of nursing care (outcome variables) from hospitals participating in both the ongoing California Nursing Outcomes Coalition statewide database project and the statewide Patients' Evaluation of Performance in California project, with data available on both measures for the same time periods, were examined. Analytic methods included both descriptive and inferential statistics.


RESULTS
Hospitals with wide ranges of staffing levels showed similar results in patient perceptions of nursing care. Regression analysis revealed a statistically significant relationship between nursing hours per patient day, and 1 of the 6 dimensions of care measured ("respect for patient's values, preferences, and expressed needs").


CONCLUSIONS
Nurse staffing alone showed a significant but weak relationship to patient perceptions of their care, indicating that staffing is likely only one of several relevant variables influencing patient perceptions of their nursing care. This research contributes data to the body of knowledge regarding nurse staffing. It is essential that nurse executives integrate results from this and other studies in developing strategic and tactical staffing plans that yield positive patient care outcomes.
Bolton
Linda Burnes
LB
Cedars-Sinai health System/Burns and Allen Research Institute, Los Angeles, Calif, USA. Bolton@cshs.org
Aydin
Carolyn E
CE
Donaldson
Nancy
N
Brown
Diane Storer
DS
Nelson
Marsha S
MS
Harms
Dorel
D
D002140:California; D002755:Choice Behavior; D019538:Health Care Surveys; D006301:Health Services Needs and Demand; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D009718:Nurse Administrators; D015401:Nursing Administration Research; D009732:Nursing Care / Q000523:psychology / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000600:supply & distribution*; D009745:Nursing, Supervisory; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D010561:Personnel Staffing and Scheduling / Q000592:standards / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011787:Quality of Health Care; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D017749:Total Quality Management; D016526:Workload