In-hospital mortality as the side effect of missed care

Abstract

Aim: The aim of the study was to assess the influence of the number of hours of daily nursing care for NHPPD in medical departments on missed care and the correlation between NHPPD and in-hospital mortality.

Background: Patient mortality can be a consequence of missed care as it correlates with the nurse-patient ratio. One of the methods to measure missed care is the Nursing Hours per Patient Day rating.

Methods: The study sample included 44,809 patients including 971 deaths in 8 wards. The influence of nursing hours, nursing education, and the percentage of patients' classification on in-hospital mortality were evaluated with backward stepwise linear regression.

Results: One hour added to the average NHPPD in medical departments was related to a decrease in mortality rate by 6.8 per 1,000 patient days and a lower chance for the emergence of unplanned death by 36%.

Conclusions: The number of NHPPD and the percentage of professional nurses are factors influencing missed care and in-hospital mortality.

Implications for nursing management: The severe consequences of missed care, that is mortality, and the correlation between in-hospital mortality, nursing education and nursing-patient ratio, which are indicators of care quality, are arguments for maintaining adequate staffing levels to avoid missed care.