Discussion
This study demonstrates that there is a relationship between
the actual hours of nursing care (HPPD) and nursing
teamwork. A higher proportion (skill mix) of nurse
staffing (i.e., more RNs in the mix of staff) also results
in better nursing teamwork. This finding substantiates
previous research showing that nursing staff perceptions
of staffing adequacy as well as number of patients they
reported caring for on the previous shift was associated
with a higher level of teamwork (Kalisch & Lee, 2009).
The use of actual nurse staffing data in the current study
adds substantial credibility and confidence to the previous
findings.