Table 4. Effects of Workload Variables on Missed Care Outcomes When Modeled Separately.
| Outcome | Workload Measures | |||
|---|---|---|---|---|
| Staffing Ratio | Infant Acuity Score, OR (95% CrI)b,c | NASA-TLX Rating, OR (95% CrI)b,c | ||
| No. of Infants per Nursea | OR (95% CrI)b | |||
| Any missed care | 2:1 | 1.23 (0.97-1.57) | 1.06 (1.04-1.07)d | 1.22 (1.19-1.24)d |
| ≥3:1 | 2.51 (1.81-3.47)d | |||
| Missed hourly IV site assessment | 2:1 | 2.98 (2.17-4.02)d | 0.99 (0.97-1.01) | 1.22 (1.18-1.25)d |
| ≥3:1 | 7.25 (4.16-11.84)d | |||
| Missed central venous catheter infection prevention bundle | 2:1 | 2.44 (1.60-3.41)d | 0.99 (0.97-1.01) | 1.21 (1.16-1.25)d |
| ≥3:1 | 6.39 (3.31-10.87)d | |||
| Missed oral feeding | 2:1 | 2.06 (0.71-5.12) | 1.05 (1.01-1.09) | 1.21 (1.16-1.27)d |
| ≥3:1 | 4.58 (1.48-11.70)d | |||
| Missed patient assessment | 2:1 | 2.65 (1.65-4.23)d | 1.01 (0.99-1.03) | 1.34 (1.30-1.39)d |
| ≥3:1 | 7.15 (4.05-12.21)d | |||
| Missed obtaining laboratory samples | 2:1 | 1.22 (0.73-1.98) | 1.00 (0.97-1.02) | 1.16 (1.10-1.22)d |
| ≥3:1 | 1.37 (0.45-3.07) | |||
| Missed parent involvement | 2:1 | 0.77 (0.47-1.21) | 1.04 (1.02-1.07)d | 1.16 (1.12-1.21)d |
| ≥3:1 | 1.61 (0.83-2.90) | |||
| Missed ventilator-associated respiratory infection prevention bundle | 2:1 | 1.47 (0.84-2.50) | 1.03 (1.00-1.07) | 1.18 (1.10-1.26)d |
| ≥3:1 | 3.51 (1.11-8.22) | |||
| Missed handoff | 2:1 | 1.07 (0.64-1.69) | 1.00 (0.98-1.03) | 1.23 (1.18-1.29)d |
| ≥3:1 | 3.59 (1.85-6.47)d | |||
| Missed 6 rights during medication administration | 2:1 | 1.55 (0.93-2.75) | 1.03 (1.01-1.06)d | 1.23 (1.17-1.29)d |
| ≥3:1 | 1.70 (0.69-3.53) | |||
| Missed double-check of high-risk medications | 2:1 | 0.91 (0.50-1.58) | 1.03 (0.99-1.06) | 1.13 (1.04-1.21)d |
| ≥3:1 | 0.83 (0.08-2.79) | |||
| Missed standard safety checks of equipment and alarms | 2:1 | 1.75 (0.83-3.71) | 1.00 (0.98-1.03) | 1.20 (1.14-1.26)d |
| ≥3:1 | 4.26 (1.65-9.71)d | |||
Abbreviations: IV, intravenous; NASA-TLX, National Aeronautics and Space Administration Task Load Index; OR, odds ratio; 95% CrI, 95% credible interval.
a
Reference category was 1 infant per nurse (1:1 ratio).
b
Each model controlled for nurse education, certification, experience, unit census, and shift start time.
c
Rescaled to indicate change in odds per 5-unit increase in score.
d
P < .004, α corrected for false discovery rate.