Association between staffing shortfall and nurse perceptions of staffing adequacy: univariable and multivariable models
| Variable | Enough staff for quality | Nursing care left undone | Staff breaks missed | |||||||||
| OR* | Adjusted OR | 95% CI | P value | OR* | Adjusted OR | 95% CI | P value | OR* | Adjusted OR | 95% CI | P value | |
| Registered nurse shortfall (HPPD) | 0.94 | 0.89 | (0.87 to 0.92) | 0.000 | 1.09 | 1.14 | (1.08 to 1.20) | 0.000 | 1.08 | 1.12 | (1.06 to 1.18) | 0.000 |
| Nursing assistant shortfall (HPPD) | 0.90 | 0.86 | (0.83 to 0.89) | 0.000 | 1.08 | 1.14 | (1.07 to 1.20) | 0.000 | 1.06 | 1.11 | (1.05 to 1.17) | 0.000 |
| Turnover (per nursing hour) | 0.35 | 0.91 | (0.30 to 2.75) | 0.863 | 7.16 | 3.36 | (0.60 to 18.72) | 0.167 | 3.85 | 4.94 | (0.95 to 25.78) | 0.058 |
| Unit type | ||||||||||||
| Medical or mixed (ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Surgical | 0.57 | 0.54 | (0.31 to 0.92) | 0.023 | 2.00 | 2.13 | (1.19 to 3.82) | 0.011 | 2.13 | 2.15 | (1.23 to 3.78) | 0.008 |
| Proportion single rooms | 0.89 | 0.54 | (0.18 to 1.66) | 0.283 | 1.58 | 3.01 | (0.93 to 9.71) | 0.065 | 1.05 | 2.06 | (0.65 to 6.56) | 0.221 |
| Day of week | ||||||||||||
| Monday (ref) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | ||||||
| Tuesday | 1.11 | 1.12 | (0.99 to 1.26) | 0.079 | 0.86 | 0.86 | (0.69 to 1.06) | 0.160 | 0.94 | 0.71 | (0.58 to 0.88) | 0.001 |
| Wednesday | 1.28 | 1.28 | (1.13 to 1.45) | 0.000 | 0.95 | 0.96 | (0.78 to 1.18) | 0.684 | 1.01 | 0.61 | (0.49 to 0.76) | 0.000 |
| Thursday | 1.09 | 1.08 | (0.96 to 1.23) | 0.200 | 0.90 | 0.91 | (0.73 to 1.13) | 0.383 | 0.96 | 0.81 | (0.66 to 1.00) | 0.045 |
| Friday | 1.03 | 1.03 | (0.91 to 1.17) | 0.610 | 0.93 | 0.93 | (0.74 to 1.15) | 0.488 | 1.03 | 0.79 | (0.64 to 0.97) | 0.028 |
| Saturday | 1.28 | 1.29 | (1.14 to 1.47) | 0.000 | 0.74 | 0.75 | (0.60 to 0.95) | 0.016 | 0.86 | 0.50 | (0.40 to 0.64) | 0.000 |
| Sunday | 1.02 | 1.02 | (0.90 to 1.15) | 0.811 | 1.08 | 1.11 | (0.90 to 1.37) | 0.310 | 0.84 | 0.82 | (0.66 to 1.01) | 0.058 |
| Variance partition coefficient for units** | 0.22 | 0.22 | 0.23 | |||||||||
| Variance partition coefficient for hospitals** | 0.12 | 0.17 | 0.11 | |||||||||
| Akaike information criterion | 20 697 | 8377 | 8094 | |||||||||
| Bayesian information criterion | 20 809 | 8490 | 8206 | |||||||||
Ref: reference category for categorical variables.
*OR derived from entering this variable only into the multilevel model. **Calculated as between-group residual variance divided by total variance using the latent variable approach.46
HPPD, hours per patient day.