Nurses’ Awareness and Compliance with Nurse-Patient Assignment
DOI:
https://doi.org/10.5281/zenodo.21375624Keywords:
nurse-patient assignment, nurses’ awareness, compliance, patient acuity, staffing, FBANDAbstract
This quantitative study assessed nurses’ awareness of and compliance with nurse-patient assignment procedures in a Level III government hospital in Quezon Province and used the findings to develop the Focused Bedside Assignment Nursing Determination (FBAND) guide. A descriptive-survey, descriptive-comparative, and descriptive-evaluative design was employed among 73 registered nurses from the service wards and medical intensive care unit selected through purposive sampling. Data were collected through a researcher-designed, expert-validated, and pilot-tested questionnaire covering patient acuity, patient characteristics, patterns of work schedules, staff involvement, and availability of resources. The subscales demonstrated high internal consistency, with Cronbach’s alpha values ranging from .838 to .970. Frequency and percentage, weighted arithmetic mean, Shapiro-Wilk and Levene tests, Mann-Whitney U, Kruskal-Wallis H, and Dunn-Bonferroni procedures were used at the .05 level of significance. The respondents were predominantly 22–30 years old, female, staff nurses, employed for more than five years, and assigned to the Medical Ward. Overall awareness was extremely high (WAM = 3.55), while compliance was high (WAM = 3.39). Patient acuity obtained the highest awareness mean (3.63), whereas staff involvement obtained the highest compliance mean (3.48). Patterns of work schedules received the lowest domain means for both awareness (3.47) and compliance (3.26). Age significantly differentiated awareness of patient acuity and patient characteristics, while area of assignment significantly differentiated several awareness and compliance domains. Nurses in the Surgery Ward consistently obtained the lowest means in the significant area-based comparisons. The findings indicate that strong conceptual awareness does not automatically ensure uniform operational compliance, particularly under scheduling, workload, and unit-specific pressures. The proposed FBAND guide integrates patient-acuity scoring, early-warning assessment, nursing care hours, staff competence, resource availability, and participatory assignment decisions to support more equitable and responsive staffing.
Downloads
References
Aaberg, O. R., Ballangrud, R., Husebø, S. E., & Hall-Lord, M. (2019). An interprofessional team training intervention with an implementation phase in a surgical ward: A controlled quasi-experimental study. Journal of Interprofessional Care, 39(1), 57–66. https://doi.org/10.1080/13561820.2019.1697216
Aksu, M., & Dinc, L. (2023). A study on nurses’ perspectives of work schedules. Sağlık ve Hemşirelik Yönetimi Dergisi, 10(2), 249–260. https://doi.org/10.54304/shyd.2023.43255
Allen, S. B. (2018). 8 steps for making effective nurse-patient assignments. American Nurse. https://www.myamericannurse.com/wp-content/uploads/2018/09/ant9-Assignments-822.pdf
Arends, S. A., Thodé, M., de Veer, A. J. E., Pasman, H. R. W., Francke, A. L., & Jongerden, I. P. (2022). Nurses’ perspective on their involvement in decision-making about life-prolonging treatments: A quantitative survey study. Journal of Advanced Nursing, 78(9), 2884–2893. https://doi.org/10.1111/jan.15223
Bacon, C. T., McCoy, T. P., Jenkins, M., Gontarz, J., & Mittal, A. K. (2024). Developing a nursing workload intensity staffing model. JONA: The Journal of Nursing Administration, 54(10), 568–573. https://doi.org/10.1097/NNA.0000000000001490
Bae, S. (2023). Assessing the impacts of nurse staffing and work schedules on nurse turnover: A systematic review. International Nursing Review, 71(1), 168–179. https://doi.org/10.1111/inr.12849
Barker, H. R., Griffiths, P., & Dall’Ora, C. (2025). “I don’t think there’s necessarily a one size fits all”: Negotiating competing priorities in nurse shift scheduling—A qualitative study. BMC Nursing, 24, Article 1048. https://doi.org/10.1186/s12912-025-03705-6
Bartmess, M., Myers, C. R., & Thomas, S. P. (2021). Nurse staffing legislation: Empirical evidence and policy analysis. Nursing Forum, 56(3), 660–675. https://doi.org/10.1111/nuf.12594
Berhanu, R. D., Tesema, A. A., Deme, M. B., & Kanfe, S. G. (2021). Perceived transcultural self-efficacy and its associated factors among nurses in Ethiopia: A cross-sectional study. PLOS ONE, 16(7), e0254643. https://doi.org/10.1371/journal.pone.0254643
Boakye, P. (2022). “No other alternative than to compromise”: Experiences of midwives/nurses providing care in the context of scarce resources. Nursing Inquiry, 29(4), e12496. https://doi.org/10.1111/nin.12496
Caron, I., Gélinas, C., Boileau, J., Frunchak, V., Casey, A., & Hurst, K. (2021). Initial testing of the use of the Safer Nursing Care Tool in a Canadian acute care context. Journal of Nursing Management, 29(6), 1801–1808. https://doi.org/10.1111/jonm.13300
Chang, H. E., & Manojlovich, M. (2023). Clinical nurses’ patient safety competency, systems thinking and missed nursing care: A cross-sectional survey. International Journal of Nursing Practice, 29(2), e13130. https://doi.org/10.1111/ijn.13130
Choi, J., & Miller, P. (2018). Registered nurse perception of patient assignment linking to working conditions and outcomes. Journal of Nursing Scholarship, 50(5), 530–539. https://doi.org/10.1111/jnu.12418
Endacott, R., Pattison, N., Dall’Ora, C., Griffiths, P., Richardson, A., & Pearce, S. (2022). The organisation of nurse staffing in intensive care units: A qualitative study. Journal of Nursing Management, 30(5), 1283–1294. https://doi.org/10.1111/jonm.13611
Gasperini, B., Pelusi, G., Frascati, A., Sarti, D., Dolcini, F., Espinosa, E., et al. (2021). Predictors of adverse outcomes using a multidimensional nursing assessment in an Italian community hospital. PLOS ONE, 16(4), e0249630. https://doi.org/10.1371/journal.pone.0249630
Jönsson, S., Stavreski, H., & Muhonen, T. (2021). Preceptorship as part of the recruitment and retention strategy for nurses? A qualitative interview study. Journal of Nursing Management, 29(6), 1841–1847. https://doi.org/10.1111/jonm.13319
Labrague, L. J. (2021). Linking nurse practice environment, safety climate and job dimensions to missed nursing care. International Nursing Review, 69(3), 350–358. https://doi.org/10.1111/inr.12736
Labrague, L. J., Sabei, S. A., AbuAlRub, R., Burney, I., & Rawajfah, O. A. (2024). The role of nurses’ adherence to clinical safety guidelines in linking nurse practice environment to missed nursing care. Journal of Nursing Scholarship, 57(2), 354–362. https://doi.org/10.1111/jnu.13017
Putra, K. R., Dewi, F. M., Rahmayanti, A. D., & Budiati, A. (2021). The correlation of nurse and equipment availability with acute missed nursing care at hospitals. Jurnal Administrasi Kesehatan Indonesia, 9(2), 150–160. https://doi.org/10.20473/jaki.v9i2.2021.150-160
Saha, A. K., Akhter, J., Mittra, C. R., Reza, H. M., & Khatun, M. R. A. (2020). Workload and job satisfaction among nurses in a tertiary level hospital. Asian Journal of Medical and Biological Research, 6(2), 359–365. https://doi.org/10.3329/ajmbr.v6i2.48084
Sapar, L. C., & Oducado, R. M. F. (2021). Revisiting job satisfaction and intention to stay: A cross-sectional study among hospital nurses in the Philippines. Nurse Media Journal of Nursing, 11(2), 133–143. https://doi.org/10.14710/nmjn.v11i2.36557
Scheepers, N., Coetzee, S., & Fourie, E. (2025). Early-career registered nurses’ work experience and nurse outcomes in South African hospitals: A cross-sectional survey. BMC Nursing, 24, Article 523. https://doi.org/10.1186/s12912-025-03188-5
Tussing, T. E., Chipps, E., & Tornwall, J. (2022). Next generation of nurses. JONA: The Journal of Nursing Administration, 52(11), 569–571. https://doi.org/10.1097/NNA.0000000000001211
Vaismoradi, M., Tella, S., Logan, P. A., Khakurel, J., & Vizcaya-Moreno, F. (2020). Nurses’ adherence to patient safety principles: A systematic review. International Journal of Environmental Research and Public Health, 17(6), 2028. https://doi.org/10.3390/ijerph17062028
Vázquez-Calatayud, M., Pumar-Méndez, M. J., & Oroviogoicoechea, C. (2024). A bottom-up framework for nurses’ protocol-based care decision-making. Nursing Open, 11(9), e2232. https://doi.org/10.1002/nop2.2232
Wagner, J., MacPhee, M., Udod, S., Berry, L., Perchie, G., & Conway, A. (2021). Surveys conducted pre- and post-implementation of a synergy tool: Giving voice to emergency teams. Journal of Nursing Management, 29(6), 1771–1777. https://doi.org/10.1111/jonm.13317
Wang, L., Lu, H., Dong, X., Huang, X., Li, B., Wan, Q., & Shang, S. (2020). The effect of nurse staffing on patient-safety outcomes: A cross-sectional survey. Journal of Nursing Management. https://doi.org/10.1111/jonm.13138
Ware, A., Blumke, T. L., Hoover, P., & Arreola, D. M. (2024). Calculating optimal patient-to-nursing capacity: Comparative analysis of traditional and new methods. JMIR Nursing, 7, e59619. https://doi.org/10.2196/59619
Warshawsky, N. E., Cramer, E., Grandfield, E. M., & Schlotzhauer, A. E. (2022). The influence of nurse manager competency on practice environment, missed nursing care, and patient care quality: A cross-sectional study of nurse managers in U.S. hospitals. Journal of Nursing Management, 30(6), 1981–1989. https://doi.org/10.1111/jonm.13649
Wiseman, T., Kourouche, S., Jones, T., Kennedy, B., & Curtis, K. (2023). The impact of whole-of-patient nursing assessment frameworks on hospital inpatients: A scoping literature review. Journal of Advanced Nursing, 80(9), 3448–3463. https://doi.org/10.1111/jan.16025
Yuwanto, M. A. (2022). The benefit of shift work schedules for nurses’ outcomes: A systematic review. Jendela Nursing Journal, 6(2), 91–100. https://doi.org/10.31983/jnj.v6i2.9224
Zalon, M. L., Ludwick, R., & Patton, R. M. (2024). Strengthening nurses’ influence in health policy. AJN, American Journal of Nursing, 124(9), 28–36. https://doi.org/10.1097/01.NAJ.0001028316.80475.bf
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
