Nursing Workload and Staffing Adequacy as Healthcare Workforce Management Factors Associated with Missed Nursing Care among Registered Nurses in Chennai

Abstract

Missed nursing care is an important concern in healthcare because omissions or delays in essential nursing activities may affect patient safety and quality of care. Regarding nursing workload and nurses' ability to perform required care activities, it is known that nursing workload is an important factor that may affect their ability to perform nursing care, but research findings have been inconsistent on the relationship between nursing workload and missed nursing care. This study set out to determine if the staffing level for nurses and the amount of work they have is predictive of missed nursing care by registered nurses. The research design used was quantitative, cross sectional, predictive correlational. Structured online questionnaire with Google forms was used for data collection and snowball sampling technique was used. The National Aeronautics and Space Administration Task Load Index (NASA-TLX), an eight-item Staffing Adequacy Scale and a 22-item MISSCARE Survey were used to assess the nursing workload, staffing adequacy and missed nursing care, respectively. One hundred and one responses were received, and 100 of these were complete responses that were analyzed. Data is analyzed by descriptive statistics, Pearson correlation and multiple linear regression software package IBM SPSS Statistics version 16.0. The results indicated that neither nursing workload nor staffing adequacy were significantly associated with the missed nursing care (β = 0.105, p = 0.275; β = 0.377, p < 0.001). The positive regression coefficient meant that reduced perceived staffing adequacy was related to increase missed nursing care given that higher scores on the Staffing Adequacy Scale represented poorer perceived staffing adequacy. Goodness of fit of the regression model was revealed by R² = 0.143 (p = 0.001), explaining 14.3% of the variance in missed nursing care. The results indicate the need for sufficient staffing in order to provide the necessary nursing care in a timely manner and that staffing conditions may contribute more than just the perception of workload. Improving staffing levels and planning for staffing needs may also help to enhance the quality of nursing care and safety of patients.