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Impact of safe nurse staffing on the quality of care in Portuguese public hospitals: A cross‐sectional study
Author(s) -
Neves Teresa Margarida Almeida,
Parreira Pedro Miguel Santos Dinis,
Rodrigues Victor José Lopes,
Graveto João Manuel Garcia Nascimento
Publication year - 2021
Publication title -
journal of nursing management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.925
H-Index - 76
eISSN - 1365-2834
pISSN - 0966-0429
DOI - 10.1111/jonm.13263
Subject(s) - staffing , nursing , context (archaeology) , portuguese , structural equation modeling , quality (philosophy) , health care , quality management , nursing management , nursing care , medicine , psychology , business , political science , linguistics , philosophy , epistemology , paleontology , statistics , mathematics , marketing , law , biology , service (business)
Abstract Aim To assess the impact of safe nurse staffing on the quality of care, based on the structure‐process‐outcome approach, in Portuguese hospitals. Background Safe nurse staffing is essential for the quality of care in hospital settings, together with work environment, organisational commitment and nursing practices. However, there is little evidence of its analysis in the Portuguese context. Method A cross‐sectional survey study was conducted using a sample of 850 nurses from 12 public hospital units in the central and northern regions of Portugal. Results The proposed structural equation model for quality assessment has a good fit (χ 2 / df = 2.37; CFI = 0.88, PCFI = 0.83; PGFI = 0.77, RMSEA = 0.04), showing the impact of safe nurse staffing, work environment, and affective and normative organisational commitment on the quality of care (mortality rate and adverse events). The mediating effect of nursing practices was also found. Conclusion Safe nurse staffing, which is compromised in 90% of the units, is a predictor of the quality of care through the mediating effect of nursing practices. Implications for Nursing Management The results not only highlight the need for urgent intervention but also support political decision‐making with a view to improving the access to quality care.