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Peng M, Saito S, Mo W, Guan H. Why do nurses miss nursing care? A qualitative meta-synthesis. Jpn J Nurs Sci 2024; 21:e12578. [PMID: 37987226 DOI: 10.1111/jjns.12578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
AIM The aim of this qualitative meta-synthesis was to discover the factors impacting on missed nursing care of nurses through systematic thinking. BACKGROUND Although nurses are responsible for high-quality care, missed nursing care is common, endangering patient safety. Understanding of the causes related to missed nursing care could help nursing managers improve the quality of nursing care. DESIGN A qualitative meta-synthesis guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). METHODS As a method designed to contribute to knowledge development, meta-synthesis allows for integration of qualitative study findings using thematic synthesis. Six databases were searched up to October 2021; nine studies met the inclusion and quality assessment criteria and meta-synthesis were conducted. RESULTS Three themes related to the causes why nurses missed nursing care were found. The themes included intrinsic resources (professional and ethical values, ambiguous nurse role, prioritization, education system, and knowledge), system structure (staff and resources shortage, heavy workload but limited time, and organizational management failure), and social environment (communication, working relationship and skill mix, and inappropriate ward layout). CONCLUSION The phenomenon of missed nursing care is a global tissue, with variations in its elements but also notable similarities. Meta-synthesis provides evidence of intrinsic and extrinsic factors that contribute to missed nursing care. RELEVANCE TO CLINICAL PRACTICE Recognizing and understanding the causes of missed nursing care is essential for nursing managers to ensure patient safety and the provision of high-quality care.
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Affiliation(s)
- Mengyun Peng
- School of Nursing, Soochow University, Suzhou, China
- Graduate School of Health Sciences, Okayama University, Okayama, Japan
| | - Shinya Saito
- Graduate School of Health Sciences, Okayama University, Okayama, Japan
| | - Wenping Mo
- Graduate School of Medicine, Division of Health Sciences, Osaka University, Osaka, Japan
| | - Hong Guan
- Department of Nursing, The Third Hospital of Dalian Medical University, Dalian, China
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Tait D, Davis D, Roche MA, Paterson C. Nurse/midwife-to-patient ratios: A scoping review. Contemp Nurse 2024:1-13. [PMID: 38408182 DOI: 10.1080/10376178.2024.2318361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 02/08/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND A significant body of work has linked high nurse or midwife workload to negative patient outcomes. Anecdotal reports suggest that mandated ratio models enhance patient care and improve nurse job satisfaction. However, there is limited focused research. OBJECTIVE To identify key outcomes, implementation processes, and research needs regarding nurse/midwife-to-patient ratios in the Australian healthcare context. DESIGN Scoping review. METHODS Data sources were CINAHL, Open Dissertations, Medline, and Scopus. 289 articles screened, and 53 full text documents independently assessed against criteria by two reviewers and conflicts resolved by a third reviewer, using Covidence™. Three studies were included in this review. RESULTS Studies focused on nurse (job satisfaction, burnout), patient (mortality, readmission, length of stay) and system (costs) outcomes with limited information on implementation processes and no midwifery research. CONCLUSIONS Ratios provide benefits for patients, nurses, and hospitals although there is limited research in Australia. Implementation was poorly reported..
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Affiliation(s)
- Darcy Tait
- Australian Catholic University, School of Nursing, Midwifery and Paramedicine, Faculty of Health Sciences, Watson, Australian Capital Territory, Australia
| | - Deborah Davis
- University of Canberra, School of Nursing, Midwifery and Public Health, Faculty of Health & ACT Government Health Directorate, Bruce, Australian Capital Territory, Australia
| | - Michael A Roche
- University of Canberra, School of Nursing, Midwifery and Public Health, Faculty of Health & ACT Government Health Directorate, Bruce, Australian Capital Territory, Australia
- University of Technology Sydney, School of Nursing and Midwifery, Faculty of Health, Ultimo, New South Wales, Australia
| | - Catherine Paterson
- University of Canberra, School of Nursing, Midwifery and Public Health, Faculty of Health & ACT Government Health Directorate, Bruce, Australian Capital Territory, Australia
- Robert Gordon University, School of Nursing, Midwifery & Paramedic Practice, Garthdee, UK
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Labrague LJ, T Kostovich C. A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review. West J Nurs Res 2024; 46:133-142. [PMID: 38014816 DOI: 10.1177/01939459231214598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Carol T Kostovich
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
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Zhou Q, Liu J, Zheng F, Wang Q, Zhang X, Li H, Tan L, Luo W. Nurses' preferences for interventions to improve infection prevention and control behaviors based on systems engineering initiative to patient safety model: a discrete choice experiment. BMC Nurs 2024; 23:29. [PMID: 38200529 PMCID: PMC10777601 DOI: 10.1186/s12912-024-01701-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/01/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The evidence of preferences for infection prevention and control (IPC) intervention from system perspective was lacked. This study aimed to elicit nurses' preferences for the intervention designed to improve IPC behaviors based on the Systems Engineering Initiative to Patient Safety (SEIPS) model using Discrete Choice Experiment (DCE). METHODS A DCE was conducted among nurses who were on active duty and willing to participate from July 5th to 10th, 2021 in a tertiary hospital in Ganzhou City, Jiangxi Province, using convenience sampling. A self-administered questionnaire included scenarios formed by six attributes with varying levels based on SEIPS model: person, organization, tools and technology, tasks, internal environment and external environment. A conditional logit and latent class logit model were performed to analyze the data. RESULTS A total of 257 valid questionnaires were analyzed among nurses. The results from the latent class logit model show that nurses' preferences can be divided into three classes. For nurses in multifaceted-aspect-preferred class (41.9%), positive coefficients were obtained in those six attributes. For person-preferred class (19.7%), only person was positively significant. For environment-preferred class (36.4%), the most important attribute were tasks, tools and technology, internal environment and external environment. CONCLUSIONS This finding suggest that nurses have three latent-class preferences for interventions. Multifaceted interventions to improve IPC behaviors based on the SEIPS model are preferred by most nurses. Moreover, relevant measured should be performed targeted the latent class of person-preferred and external-environment-preferred nurses.
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Affiliation(s)
- Qian Zhou
- Department of Hospital Infection Management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology , No.100 Xianggang Rd, Wuhan, Hubei Province, China
| | - Junjie Liu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Feiyang Zheng
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qianning Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xinping Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Hui Li
- Children's Oncology Department, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Li Tan
- Department of Hospital Infection Management, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, 430030, Hankou, Wuhan, China.
| | - Wanjun Luo
- Department of Hospital Infection Management, Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology , No.100 Xianggang Rd, Wuhan, Hubei Province, China.
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Nantsupawat A, Poghosyan L, Wichaikhum OA, Kunaviktikul W, Fang Y, Kueakomoldej S, Thienthong H, Turale S. Nurse staffing, missed care, quality of care and adverse events: A cross-sectional study. J Nurs Manag 2022; 30:447-454. [PMID: 34719833 PMCID: PMC9017335 DOI: 10.1111/jonm.13501] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/14/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022]
Abstract
AIM This study aimed to illustrate the relationship between nurse staffing and missed care, and how missed care affects quality of care and adverse events in Thai hospitals. BACKGROUND Quality and safety are major priorities for health care system. Nurse staffing and missed care are associated with low quality of care and adverse events. However, examination of this relationship is limited in Thailand. METHODS This cross-sectional study collected data from 1188 nurses in five university hospitals across Thailand. The participants completed questionnaires that assessed the patient-to-nurse ratio, adequacy of staffing, missed care, quality of care and adverse events. Logistic regression models were used to estimate associations. RESULTS Higher patient-to-nurse ratio, poor staffing and lack of resource adequacy were significantly associated with higher odds of reporting missed care. Higher nurse-reported missed care was significantly associated with higher odds of adverse events and poor quality of care. CONCLUSIONS Poor nurse staffing was associated with missed care, and missed care was associated with adverse events and lower quality of care in Thai university hospitals. IMPLICATIONS FOR NURSING MANAGEMENT Improving nurse staffing and assuring adequate resources are recommended to reduce missed care and adverse events and increase quality of care.
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Affiliation(s)
| | | | | | - Wipada Kunaviktikul
- Assistant to the President in Health Science Panyapiwat
Institute of Management, Nonthaburi, Thailand
| | - Yaxuan Fang
- Chiang Mai University, Faculty of Nursing, Chiang Mai,
Thailand,School of Nursing, Southern Medical University, Guangzhou,
China
| | | | - Hunsa Thienthong
- Nursing Director, Nursing Service Division, Maharaj Nakorn
Chiang Mai Hospital, Chiang Mai, Thailand
| | - Sue Turale
- Visiting Professor, Faculty of Nursing, Chiang Mai,
Thailand
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