Abstract
▶ RN and CNO perceptions of the effects of the nursing shortage on quality of care are particularly significant in the context of the overall quality movement in health care, attention to patient safety, and appreciation for nurse-sensitive outcomes. ▶ In general, RNs perceive the negative effects of the shortage on quality as more severe than CNOs, perhaps attributable to their daily intimacy with patient care. ▶ RNs (79%) and CNOs (68%) perceived the shortage as a major problem impacting quality in hospitals; RNs in other care settings such as long-term care, ambulatory care, and student health care also felt that quality of care was impacted. ▶ Several care delivery processes were cited as being impacted by the shortage including delays in nurse responses to pages or calls, increased communication problems, delays in discharge, and increased wait time for surgery, tests, and procedures. ▶ Ninety-three percent of hospital RNs reported major problems with having enough time for patients with the majority also noting major problems with having enough time to maintain patient safety, detect complications early, and collaborate with team members.