title: Do staffing levels predict missed nursing care?
abstract: OBJECTIVE
  To examine whether actual nurse staffing predicts missed nursing care, controlling for other unit characteristics.
  
  
  METHODS
  This study utilized a cross-sectional, descriptive design.
  
  
  METHODS
  Ten hospitals in the Midwestern region of the USA.
  
  
  METHODS
  Nursing staff members with direct care responsibilities (n = 4288) on 110 care units.
  
  
  METHODS
  The MISSCARE Survey was utilized to capture respondents' perceptions of missed nursing care as well as other unit characteristics (i.e. demographics, work schedules and absenteeism). Actual staffing data (hours per patient day [HPPD], registered nurse hours per patient day [RN HPPD], skill mix) and unit level case mix index were collected from the participating hospitals for the mean scores of 2 months during survey distribution.
  
  
  RESULTS
  HPPD was a significant predictor of missed nursing care (β = -0.45, P = 0.002).
  
  
  CONCLUSIONS
  Findings from this study suggest that missed nursing care may explain, at least in part, the relationship between staffing levels and patient outcomes.
authors.affiliation: University of Michigan School of Nursing, Ann Arbor, MI 48109, USA. bkalisch@umich.edu
authors.forename: Beatrice J
authors.initials: BJ
authors.lastname: Kalisch
authors.forename: Dana
authors.initials: D
authors.lastname: Tschannen
authors.forename: Kyung Hee
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015146:Midwestern United States; D009732:Nursing Care / Q000592:standards; D009736:Nursing Process / Q000592:standards* / Q000639:trends; D010561:Personnel Staffing and Scheduling; D000078329:Workforce; D016526:Workload; D055815:Young Adult