1. FOR Sissy.. =p definition of variables, Methods (which includes the schema and the tools we used), assumptions

2. Methods

3. A cross-sectional study Questionnaires were used as primary instrument for data collection in the assessment of patient’s satisfaction. Convenience sampling was applied to select the patients for the survey. Existing hospital records (Human Resources Data and Admission Records, as reported by the Nursing Service Department) were obtained to serve as data for nurse turnover rate, nurse/patient ratio, and percentage of nurses undergoing overtime work.

4. SCHEMA of the Study

6. Data were collected using self-administered questionnaires for patients, aside from existing records acquired from hospital nursing service department. The questionnaire for qualified patients would enable the investigators to determine the proportion of satisfied patients. The content of the questionnaire was based upon the application of Nursing Standard of Care. It was comprised of two major parts, the first, evaluating the behavior of nurses towards the patients, and the second, skill-related tasks of nurses during bedside care.

7. From the survey questionnaire, Behavior on Bedside and Task-related Skills were assigned 60% and 40% respectively. Each subheading under the two categories was likewise assigned weight in percentage. Total weighted scores were then computed. Total weighted score was then checked against the definition of the level of satisfaction of patient, as listed below: Total Weighted Score: > or = 3.00 - satisfied 0.00 – 2.99- not satisfied

8. Inclusion Criteria

9. Inclusion Criteria for Participating Hospitals The hospital invited to participate in the study was at least secondary private hospitals Hospitals invited to participate would have to come from a geographic cluster Hospital administrators or staff should have expressed willingness to cooperate in the study. Hospital should have a Medicine Ward.

10. Patients: Inclusion criteria The patient should have been admitted in the Medicine Ward of the participating hospital. S/he should have stayed in the Ward for at least three days duration, at the time of the survey administration. S/he should be conscious, fairly reliable, and has stable vital signs. S/he should be constantly accompanied by a fairly reliable relative or friend who can assist with or attest to the answering of the questionnaire. S/he must be able to identify at least one staff nurse who has attended to her/him consistently for the past three days of confinement.

11. Exclusion Criteria

12. Patient: Exclusion criteria The patient does not understand the language in which the questionnaire was written. S/he refused to participate because of difficulty observing the nurse or answering the questionnaire due to her/his clinical condition. S/he required total patient care.

13. Variables

14. Inadequacy of workforce – operationally defined as having at least two of the following combination of rates: (1) high external turnover rate, or the rate by which the hospital gains and loses nurses to another hospital, industry or country (greater than or equal to 22%) (Jones & Gate, 2007) (2) high nurse/patient ratio (higher than 1:6) (CHA, 2003 cited by Scott, 2005; RCN, 2003; Stanton, 2004); and (3) increased number of nurses working overtime, (if the percentage of nurses working for > 40 hours/week is > or = 3%)

15. State of satisfaction – operationally defined as the condition by which the patient feels that s/he is taken good bedside care of, at the same time maintaining good relationship with her/his nurse, expressed as the observed frequency by which the attending nurse performs the tasks expected of her. Specifically, a.) satisfied if the patient's response has a mean weighted score of 3.00 or above. b.) not satisfied if the mean weighted score is below 3.00.

16. Assumptions

17. There is no one variable that can accurately determine presence of inadequacy of workforce. It was also assumed that when there is at least two of the following: (inadequacy exists) high turnover rate (greater than or equal to 22%) high nurse/patient ratio (higher than 1:6) increased number of nurses working for more than 40 hours/week (greater than 3%) This study further assumed that inadequacy of workforce is, by and large, a consequence of nurse migration.