Children’s nurses omit care in ‘poor work environments’, says new study

Children’s nurses with poor work environments and higher patient loads are more likely to omit some care activities, a study suggests.

More than half of 2,180 nurses surveyed reported missing out at least one care activity in their previous shift, US researchers found.

Nurses were 40% less likely to omit care in better environments, according to the study by the University of Pennsylvania School of Nursing’s Center for Health Outcome and Policy Research and the Children’s Hospital of Philadelphia.

For every additional patient, nurses were 70% more likely to miss a care activity.

Nurses in better environments missed fewer care activities, at 1.2 activities per shift compared with 1.9 in poor environments.

Implications

Eileen Lake, professor of nursing and health policy at Penn Nursing, said: ‘The implications are that quality of care differs pretty significantly across institutions, and that if we can either provide better staffing or better work environments or both that nurses can get their care completed.

‘Completing tasks like providing education and discharge instructions helps parents have what they need to leave the hospital and feel comfortable doing so.’

The study, published in the journal Hospital Pediatrics, found care activities such as planning, comforting, teaching and counselling were missed most frequently, while pain management, treatments and procedures were missed rarely.

The quality of the environment was determined from survey responses on questions including nurses’ working relationships with physicians, whether they had a capable and supportive nurse manager and whether their resources and staffing were adequate.

There is growing evidence that nurse staffing levels have a major impact on patient outcomes including mortality rates, length of stay and failure to rescue.

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