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What Explains Nurses’ Perceptions of Staffing Adequacy?

Mark, Barbara A. PhD, RN, FAAN

Journal of Nursing Administration: May 2002 - Volume 32 - Issue 5 - p 234-242

Background Much attention is being paid to the adequacy of nurse staffing in acute care hospitals, and much of the information relies on nurses’ perceptions about staffing adequacy. Yet, we know little about what influences these perceptions.

Objectives We examined the impact of hospital characteristics, nursing unit characteristics, nurse characteristics, and patient characteristics on nurses’ perceptions of staffing adequacy. We tested three different models, incorporating different conceptualizations that relate current and past characteristics to these perceptions.

Method This was a secondary analysis of data from the Outcomes Research in Nursing Administration Project, a longitudinal study conducted in 60 hospitals in the Southeastern United States.

Results Perceptions of staffing adequacy were influenced significantly by the hospital’s case mix index and growth in hospital admissions, by the number of beds on a unit, and by patient acuity. Further, current perceptions of staffing adequacy were significantly affected by prior perceptions.

Conclusion Based on our results, we present potential interventions for administrators that may ameliorate some of the negative influences on nurses’ perceptions of staffing adequacy.

Supplemental Digital Content is Available in the Text.

Author affiliations: University of North Carolina at Chapel Hill (Dr Mark); Department of Adult Health Nursing, School of Nursing (Dr Salyer); Department of Economics, School of Business, (Dr Harless), Virginia Commonwealth University, Richmond, Va.

Corresponding author: Barbara A. Mark, PhD, RN, FAAN, University of North Carolina at Chapel Hill, Carrington Hall CB#7460, Chapel Hill, NC 27599-7460 (

Funded by a grant from the National Institute of Nursing Research (R0103149), Barbara A. Mark, PhD, RN, FAAN, Principal Investigator.

© 2002 Lippincott Williams & Wilkins, Inc.