Implications for practice and research

• The level of nurse staffing influences the priority nurses give to surveillance; nursing units should be adequately staffed to support the surveillance of all patients.

• Managers should routinely check with staff nurses to learn which patients they are monitoring most frequently.

• Nurses caring for postoperative patients should give extra attention to patients with comorbidities.

• Nursing systems research should focus on the pathways through which nursing system features influence care processes and patient outcomes.

Context

Over the past decade, considerable evidence from cross-sectional studies has established that patient outcomes are better in hospitals with better nursing features, with staffing being the dominant feature studied.1 Other prominent …