Do staffing levels predict missed nursing care?

Beatrice J. Kalisch, Dana Tschannen, Kyung Hee Lee

Research output: Contribution to journalArticlepeer-review

123 Citations (Scopus)


Objective: To examine whether actual nurse staffing predicts missed nursing care, controlling for other unit characteristics. Design: This study utilized a cross-sectional, descriptive design. Setting: Ten hospitals in the Midwestern region of the USA. Participants: Nursing staff members with direct care responsibilities (n = 4288) on 110 care units. Main Outcome Measures: 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 = 20.45, 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.

Original languageEnglish
Article numbermzr009
Pages (from-to)302-308
Number of pages7
JournalInternational Journal for Quality in Health Care
Issue number3
Publication statusPublished - 2011 Jun

Bibliographical note

Funding Information:
This work was supported by the Blue Cross and Blue Shield Foundation of Michigan.

All Science Journal Classification (ASJC) codes

  • Health Policy
  • Public Health, Environmental and Occupational Health


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