title: Relationships Between Nurse Staffing and Patients' Experiences, and the Mediating Effects of Missed Nursing Care.
abstract: The aims of this study were to examine the relationships between nurse staffing and patients' experiences, and to determine the mediating effects of patient-reported missed care on the relationship between nurse staffing and patients' experiences.
  
  
  
  The study included 362 nurses and 208 patients from 23 nursing units of six hospitals in South Korea.
  
  
  
  Nurse staffing was measured by patient-to-nurse ratios and by nurse- and patient-perceived staffing adequacy. Patients' experiences included adverse events, communication with nurses, and overall hospital rating. Patient-reported missed care was measured using the MISSCARE Survey-Patient with three domains: communication, basic care, and timely response.
  
  
  
  Lower nurse-perceived staffing adequacy was associated with more patient-reported missed communication. Lower patient-perceived staffing adequacy was associated with more missed care and adverse events, and a lower likelihood of experiencing good communication with nurses and of giving a high overall rating to the hospital. Patient-reported missed care mediated the relationship between nurse staffing and patients' experiences.
  
  
  
  Nurse staffing adequacy, particularly as perceived by patients, was significantly associated with patient-reported missed communication and basic care, as well as patients' experiences.
  
  
  
  Appropriate nurse staffing is required to reduce missed care and to improve patients' experiences.
authors.affiliation: Professor, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, South Korea.
authors.forename: Sung-Hyun
authors.initials: SH
authors.lastname: Cho
authors.affiliation: Sarah Frances Russell Distinguished Professor, School of Nursing, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Mark
authors.affiliation: Professor, School of Nursing, University of North Carolina, Chapel Hill, NC, USA.
authors.forename: George
authors.initials: G
authors.lastname: Knafl
authors.affiliation: Doctoral Student, College of Nursing, Seoul National University, Seoul, South Korea.
authors.forename: Hyoung Eun
authors.initials: HE
authors.lastname: Chang
authors.affiliation: Doctoral Student, College of Nursing, Seoul National University, Seoul, South Korea.
authors.forename: Hyo-Jeong
authors.initials: HJ
authors.lastname: Yoon
mesh_terms: D019538:Health Care Surveys; D006801:Humans; D009723:Nurse-Patient Relations; D009732:Nursing Care / Q000592:standards*; D015403:Nursing Evaluation Research; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000600:supply & distribution*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data*; D011787:Quality of Health Care; D056910:Republic of Korea
keywords: Adverse events; missed nursing care; nurse staffing; patients' experience