The nurse-patient assignment is the matching of the nurse and patient for a specified time for the provision of nursing care. The nurse-patient assignment affects the quality of nursing care received by hospitalized patients. The current nursing shortage is a potential risk to patient safety in addition to the quality of nursing care received by patients. Improving the nurse-patient assignment process through critical examination of the process and the development of best practices can enhance patient safety and quality of nursing care while maximizing the use of limited resources.

The purpose of this exploratory descriptive study was to describe the nurse-patient assignment process. Specifically, this study sought to identify purposes, decision factors and steps of the process. Fourteen charge nurses representing 11 nursing units of a suburban hospital in the Southeastern United States were interviewed using a semi-structured interview guide. The data was analyzed using Krippendorff's method of content analysis. Results were presented in narrative and Venn diagram form.

Purposes of the nurse-patient assignment process were interrelated among patient, nurse and nursing environment domains. Best care was the overarching purpose of the nurse-patient assignment. Participants across units strove to make nurse-patient assignments where best care was a priority while ensuring that nurses were treated equitably and the work of the unit was completed. The most common decision factors were related to patient and nurse demographics, acuity, proximity, competence, workload, nurse-patient ratio, collegiality and staffing. Participants on each type of unit considered factors that were specific to their unit environments. Participants described three pathways to making nurse-patient assignments which corresponded to the type of nursing unit (episodic care, acute care/short stay and long stay) on which they worked.

Unit type and characteristics played a role in the differences seen amongst the three types of units related to purposes, decision factors and steps of the nurse-patient assignment. This research built on the current knowledge related to the nurse-patient assignment process and expanded our knowledge to include consideration of the nurse, patient and environment when making nurse-patient assignments.