1
|
Azizi Z, Naghizadeh MM, Bijani M. The relationship between moral courage, team work, and safe nursing care in clinical nurses: a multicenter cross-sectional study in Iran. BMC Nurs 2024; 23:411. [PMID: 38898506 PMCID: PMC11186086 DOI: 10.1186/s12912-024-02097-3] [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: 03/29/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Moral courage and team work are the most important aspects of professional competence in clinical nurses; nurses with moral courage and team work are thought to be able to deliver safe nursing care to patients. The present study aimed to investigate whether moral courage and teamwork correlate with safe nursing care among clinical nurses. METHODS This descriptive cross-sectional multicenter study was carried out from December 2023 to February 2024. A total of 375 nurses who were practicing in four hospitals in the south of Iran were enrolled in this study using convenience sampling. The data collection tools used consisted of a demographics survey, Moral Courage Questionnaire (MCQ), Team STEPPS Team Perception Questionnaire (T-TPQ), and the Assessment of Safe Nursing Care Questionnaire (ASNCQ). The data were analyzed using descriptive statistics, t-test, chi-square, multiple regression analysis, and Pearson's correlation coefficient. SPSS version 22 was used to analyze the data. RESULTS The participants' mean age was 32.66 ± 6.63 years, and their work experience was 8.56 ± 6.22 years. The total mean scores for moral courage, teamwork, and safe care were 422.37 ± 52.92, 144.09 ± 18.43, 315.84 ± 41.95, respectively. A statistically significant positive correlation was found between teamwork and safe care (r = 0.57, p < 0.001), teamwork and moral courage (r = 0.49, p = 0.002), and moral courage and safe nursing care (r = 0.59 p < 0.001). According to the results, work experience, moral courage, and teamwork explained 44.4% of the variance in safe nursing care (R2 = 0.44, p < 0.001). CONCLUSION The results indicated that the moral courage and teamwork of nurses were positively and significantly correlated with the participants' safe nursing care. Accordingly, since moral courage and teamwork are the qualities that can contribute to improving the quality of care and ensuring safe nursing care, it is recommended that nursing managers pay special attention to these factors.
Collapse
Affiliation(s)
- Zahra Azizi
- Student Research Committee, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | | | - Mostafa Bijani
- Department of Medical Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, 81936-13119, Iran.
| |
Collapse
|
2
|
Cartaxo A, Mayer H, Eberl I, Bergmann JM. Missing nurses cause missed care: is that it? Non-trivial configurations of reasons associated with missed care in Austrian hospitals - a qualitative comparative analysis. BMC Nurs 2024; 23:282. [PMID: 38671443 PMCID: PMC11055368 DOI: 10.1186/s12912-024-01923-y] [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: 01/22/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Errors of omissions affect the quality of nursing care in hospitals. The Missed Nursing Care Model explains that the reasons for missed care are linked with 1) demand for patient care, 2) labor resource allocation, 3) material resource allocation, and 4) relationship and communication factors. Scientific evidence points to a lack of adequate nursing staffing as the most important factor triggering missed care. However, it remains unclear how the different theoretical reasons for missed care are interlinked with reports on missed care from the perspective of nurses in acute care settings. The aim of this study was to explore non-trivial configurations of reasons for missed care that are associated with missed care interventions from the perspective of nurses working in general units in Austrian hospitals. METHODS A cross-sectional study was conducted. Data collection was performed using the revised MISSCARE-Austria questionnaire. Our sample consisted of 401 nurses who provided complete data. Data were analyzed using qualitative comparative analysis. Configurational models of contextual factors, reasons for missed care, and missed nursing interventions were analyzed. RESULTS In our study contextual factors were not consistent precursors of the reasons for missed care. Missed care was consistently present when the demand for patient care was high. A lack of labor resources, in combination with the other known reasons for missed care, was consistently observed when missed care occurred. Different configurations of reasons were found to be non-trivially associated with different types and frequencies of missed care. CONCLUSIONS To understand the complexity of the causal mechanisms of missed care, complexity theory may be necessary. Accordingly, a theoretical framework that acknowledges that complex systems, such as missed care, are composed of multiple interacting causal components must be further developed to guide new methodical approaches to enlighten its causal mechanisms.
Collapse
Affiliation(s)
- Ana Cartaxo
- Vienna Doctoral School of Social Sciences, University of Vienna, Universitätsstraße 7, Vienna, Austria.
- Austrian National Public Health Institute (Gesundheit Österreich GmbH, GÖG), Stubenring 6, Vienna, Austria.
| | - Hanna Mayer
- Division Nursing Science With Focus On Person-Centred Care Research, Department of General Health Studies, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, Krems, Austria
| | - Inge Eberl
- Faculty of Social Work, Catholic University of Eichstätt-Ingolstadt, Ostenstraße 26, Eichstätt, Germany
| | - Johannes M Bergmann
- Münster Department of Health, FH Münster University of Applied Sciences, Johann-Krane-Weg 21, Münster, 48149, Germany
| |
Collapse
|
3
|
Kohanová D, Solgajová A, Cubelo F. The association of teamwork and missed nursing care in acute care setting: A mixed-methods systematic review. J Clin Nurs 2024. [PMID: 38661121 DOI: 10.1111/jocn.17182] [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: 12/19/2023] [Revised: 03/11/2024] [Accepted: 04/10/2024] [Indexed: 04/26/2024]
Abstract
AIM(S) Teamwork among healthcare professionals is a key aspect of patient safety that influences the prevalence of missed nursing care. The association between teamwork and missed care in acute care hospitals is now well established in the literature. Therefore, this review aimed to synthesise the existing empirical evidence on the association between teamwork and missed care in the acute care setting. DESIGN A mixed-method systematic review study. METHODS The search was carried out in February 2023 in four scientific databases, PubMed, ProQuest, Web of Science and Scopus based on their institutional availability. The search produced 1542 studies. The method of thematic analysis was used in data synthesis. RESULTS A total of 18 studies were selected that revealed the relationship between teamwork and missed care. The teamwork score was weak to moderate but significantly associated with the overall score of missed care and was found to be a statistically significant predictor of missed care in an acute care setting. Additionally, teamwork represented an important reason for missed care, primarily in the context of poor communication, lack of trust and cooperation in the nursing team and lack of leadership. CONCLUSION The review findings contribute to a deeper understanding of the intricate dynamics between teamwork and missed care and provide valuable information to healthcare professionals and institutions looking to optimise teamwork and mitigate instances of missed care in the acute care setting. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Recognising how teamwork influences the occurrence of missed care, healthcare organisations can strategically implement targeted interventions to enhance collaboration, address communication gaps, foster trust, and provide effective leadership. IMPACT This review suggests that improving teamwork seems to be one of the most important strategies focused on mitigating missed care in acute care settings. REPORTING METHOD The reporting of this review followed the PRISMA 2020 checklist. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Dominika Kohanová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic
| | - Andrea Solgajová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovak Republic
| | - Floro Cubelo
- School of Wellbeing and Culture, Nursing, Oulu University of Applied Sciences, Oulu, Finland
- Department of Nursing Science, Faculty of Health Sciences, Kuopio, Finland
| |
Collapse
|
4
|
Kohanová D, Bartoníčková D, Žiaková K. Missed nursing care as reported by paediatric nurses: A cross-sectional study. J Clin Nurs 2024; 33:1444-1458. [PMID: 37985425 DOI: 10.1111/jocn.16935] [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: 07/10/2023] [Revised: 10/10/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
AIMS Missed nursing care (MNC) significantly affects patient safety and quality of care. It is a widely used concept that has been studied in different settings, but research in paediatric care is quite limited. Therefore, this descriptive cross-sectional study aimed to report the prevalence, patterns, correlates, factors and predictors of MNC in paediatric care units in two central European countries. DESIGN A cross-sectional comparative study. METHODS Data collection was carried out between June and November 2021 using the MISSCARE Survey-Pediatric. The study included 441 registered nurses working in paediatric care units in the Czech Republic and Slovakia. Data were analysed using descriptive and inferential statistics in the SPSS 25.0 statistical program. RESULTS Almost all nurses, 92.7% of nurses missed at least one nursing activity during the last shift. The most missed care activity in both countries was the promotion of neuroevolutionary development, and the most prominent reasons were labour resources. MNC was weakly but significantly correlated with nurse experience in the current position and was predicted by the country, nurse education and overtime hours (p ≤ .05). Differences in prevalence of MNC and reasons for MNC were identified based on several variables (p ≤ .05). CONCLUSION The assessment of MNC in paediatric settings is often a neglected area, although the prevalence in this study was moderate. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Nurse staff shortages, as a global problem, have many impacts on patient outcomes in the delivery of nursing care. However, there are also many factors that can reduce the prevalence of MNC. More research should focus on a closer examination of these factors that involve hospital and nurse variables. REPORTING METHOD The study was carried out according to the STROBE checklist and the RANCARE guideline. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
Collapse
Affiliation(s)
- Dominika Kohanová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, Nitra, Slovakia
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovakia
| | - Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czechia
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Bratislava, Slovakia
| |
Collapse
|
5
|
Papathanasiou I, Tzenetidis V, Tsaras K, Zyga S, Malliarou M. Missed Nursing Care; Prioritizing the Patient's Needs: An Umbrella Review. Healthcare (Basel) 2024; 12:224. [PMID: 38255111 PMCID: PMC10815730 DOI: 10.3390/healthcare12020224] [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: 11/02/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/24/2024] Open
Abstract
The objective of this review of reviews was to identify the reasons for missed nursing care and to shed light on how nurses prioritize what care they miss. Missed nursing care refers to essential nursing activities or tasks that are omitted or not completed as planned during a patient's care. This omission can result from various factors, such as staffing shortages, time constraints, or communication issues, and it can potentially compromise the quality of patient care and safety. Identifying and addressing missed nursing care is crucial to ensure optimal patient outcomes and the well-being of healthcare professionals. To be included, reviews had to use the systematic review process, be available in the English language, examine missed care in hospitals and at home, and include participants who were over eighteen years old. The review intended to answer the following questions: 'Why nursing care is missed?' 'How nurses prioritize what care they missed?'. An umbrella review was developed guided by the JBI methodology and using PRISMA-ScR. A total of 995 reviews were identified. According to the inclusion criteria, only nine reviews were finally evaluated. The findings indicate that care is missed due to staffing levels, organizational problems, and the working climate. Prioritization of care depends on acute care needs as well as educational and experiential background. Missed nursing care is associated with patient safety and the quality of provided nursing care. Specifically, it has negative impacts on patients, healthcare professionals, and healthcare service units. Organizational characteristics, nursing unit features, and the level of teamwork among nursing staff affect Missed Nursing Care. Individual demographic characteristics of the staff, professional roles, work schedules, and adequate staffing may potentially contribute to the occurrence of Missed Nursing Care, which is why they are under investigation. However, further consideration is needed regarding the management of patient needs and nurse prioritization.
Collapse
Affiliation(s)
- Iokasti Papathanasiou
- Department of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.P.); (V.T.); (K.T.)
| | - Vasileios Tzenetidis
- Department of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.P.); (V.T.); (K.T.)
| | - Konstantinos Tsaras
- Department of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.P.); (V.T.); (K.T.)
| | - Sofia Zyga
- Department of Nursing, University of the Peloponnese, 22131 Tripolis, Greece;
| | - Maria Malliarou
- Department of Nursing, University of Thessaly, 41500 Larisa, Greece; (I.P.); (V.T.); (K.T.)
| |
Collapse
|
6
|
Baek H, Han K, Cho H, Ju J. Nursing teamwork is essential in promoting patient-centered care: a cross-sectional study. BMC Nurs 2023; 22:433. [PMID: 37978376 PMCID: PMC10655287 DOI: 10.1186/s12912-023-01592-3] [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: 07/11/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND There has been little research regarding nursing teamwork, despite its important role in multidisciplinary teamwork in healthcare settings and its significance in ensuring high-quality nursing care. This study aimed to determine the teamwork levels of Korean nurses and examine the relationship between nursing teamwork and patient-centered care while controlling for other individual and work-related factors. METHODS We conducted a cross-sectional analysis of online survey data. The study population consisted of 992 Korean registered nurses employed in hospitals who had a minimum of six months of clinical experience. We performed latent profile analysis to identify latent teamwork subgroups based on response patterns. We performed analysis of variance and Chi-square tests to examine differences in individual and work-related characteristics according to teamwork group. We used multiple linear regression to investigate how nursing teamwork could affect patient-centered care after controlling for covariates. RESULTS We identified three nursing teamwork subgroups: low, mid, and high. Nurses with a higher level of teamwork in their units tended to work fewer hours with more adequate staffing (F = 5.88, p = 0.003 for working hours; F = 7.68, p < 0.001 for staffing adequacy). There was a significant positive association between nursing teamwork and patient-centered care after controlling for personal and work-related characteristics. Compared with low teamwork, mid and high teamwork increased patient-centered care scores by 0.32 (95% confidence interval [CI] = 0.23-0.40) and 0.57 (95% CI = 0.48-0.66), respectively. CONCLUSION Our findings indicate that enhancing nursing teamwork can serve as an effective strategy for promoting patient-centered care. Providing nurse education and training to equip nurses with the necessary knowledge and skills for effective teamwork is a crucial step. Additionally, fostering management commitment to create a supportive working environment, including adequate staffing, can facilitate improved nursing teamwork and, subsequently, patient-centered care.
Collapse
Affiliation(s)
- Hyang Baek
- School of Nursing, University of Maryland, Baltimore, MD, 21201, USA
| | - Kihye Han
- College of Nursing, Chung-Ang University, Seoul, 06974, South Korea.
| | - Hyeonmi Cho
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, 03722, South Korea
| | - Jieun Ju
- Graduate School, Chung-Ang University, Seoul, 06974, South Korea
| |
Collapse
|
7
|
Heng LMT, Rajasegeran DD, See AMT, Kannusamy P, Lim SH, Aloweni FBAB, Ang SY. Original Research: Nurse-Reported Missed Care and Its Association with Staff Demographics and the Work Environment. Am J Nurs 2023; 123:28-36. [PMID: 37615466 DOI: 10.1097/01.naj.0000978144.33445.5b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND Nurses have primary responsibility for many of the care processes and interventions intended to improve patients' health during hospital stays. Accordingly, missed nursing care can negatively impact patient safety and lead to negative clinical outcomes. Missed nursing care is standard care that is not completed, incomplete, or seriously delayed. PURPOSE There is scant literature on nurse-reported missed care (NRMC) in Singapore. Identifying the prevalence of, types of, and reasons for missed care, including staff-related factors, is imperative to understanding the implications of missed care and identifying opportunities for improvement. METHODS Ours is a correlation study of NRMC using convenience sampling. Nurses working on all inpatient units in an acute care hospital in Singapore were recruited to complete the MISSCARE survey, a quantitative tool measuring missed nursing care and the reasons for it. Descriptive statistics was applied to analyze demographics, types of NRMC, and reasons for NRMC. The Pearson χ2 test was used to analyze the correlation between demographics and satisfaction variables and NRMC. RESULTS A total of 314 participants out of 1,944 eligible nurses (response rate, 16%) were recruited. The most commonly reported missed care activities were setting up meals for patients who can feed themselves (87.3%), ambulation (70.1%), attending interdisciplinary conferences (64.3%), providing emotional support to patients and/or family (58%), and turning patients every two hours (56.7%). The most cited reasons for missed care were inadequate number of staff (84.4%), caregiver not in unit or unavailable (76.1%), heavy admission and discharge activity (75.5%), urgent patient situations (74.2%), and unexpected rise in patient volume and/or acuity (73.2%). Younger age, greater experience in role and current unit, inadequate staffing and teamwork, low satisfaction with current role and with being a nurse, and planning to leave the current position were factors significantly associated with greater levels of missed care. CONCLUSION This study demonstrated evidence of NRMC and its associated factors within the local setting. In addition to expanding nursing resources, analyzing nursing work processes, providing support for younger nurses, and improving nursing satisfaction are possible mitigating factors in preventing missed care. Strategies targeting workforce and resource management, greater support for new and younger nurses, and job satisfaction should be considered to address missed care.
Collapse
Affiliation(s)
- Laura Mun Tze Heng
- Laura Mun Tze Heng is a staff nurse, Darshini Devi Rajasegeran and Siew Hoon Lim are nurse clinicians, Alicia Min Ting See is a senior staff nurse, and Fazila Binte Abu Bakar Aloweni is senior nurse manager, all at Singapore General Hospital, Singapore. Premarani Kannusamy is deputy director and head of nursing, Youth Preventive Services, and head of nursing, Health Promotion Board, Singapore. Shin Yuh Ang is deputy director of nursing innovation, quality and research, Singapore General Hospital, and director of nursing, National Dental Centre, Singhealth, Singapore. Contact author: Darshini Devi Rajasegeran, . The authors have disclosed no potential conflicts of interest, financial or otherwise
| | | | | | | | | | | | | |
Collapse
|
8
|
Arıkan A, Esenay FI. Missed nursing care in pediatric emergency departments in Turkey: A cross-sectional study. Appl Nurs Res 2023; 72:151699. [PMID: 37423683 DOI: 10.1016/j.apnr.2023.151699] [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: 07/02/2022] [Revised: 05/15/2023] [Accepted: 06/15/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVE A pediatric emergency department deals with a vast number of patients and a high load of emergent/high-priority healthcare practices. Therefore, at times, it is possible to experience missed nursing care in this department. This study aims to ascertain the types of and reasons for missed nursing care cases in pediatric emergency departments in Turkey. METHOD This is a cross-sectional survey study. Survey data were collected from 155 nurses using the "Introductory Information Form" and the "MISSCARE-Pediatric Emergency Department Survey." RESULTS Gastrostomy care, colostomy care, tracheotomy care, and teaching about hospital discharge were the care practices most often missed. The volume of patients, urgent patient situations, an inadequate number of nurses in charge, too many inexperienced nurses in the department, and assignment of work outside the scope of the job are the main reasons for missed care. CONCLUSION Pediatric emergency department patients experience missed nursing care and nurses should be supported more in order for them to provide efficient care to children.
Collapse
Affiliation(s)
- Aylin Arıkan
- Graduate Schools of Health Sciences at Ankara University, Ankara, Turkey.
| | - Figen Işık Esenay
- Department of Pediatric Nursing, Faculty of Nursing, Ankara University, Ankara, Turkey
| |
Collapse
|
9
|
Agostinho P, Potra T, Lucas P, Gaspar F. The Nursing Practice Environment and Patients' Satisfaction with Nursing Care in a Hospital Context. Healthcare (Basel) 2023; 11:1850. [PMID: 37444684 DOI: 10.3390/healthcare11131850] [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: 05/10/2023] [Revised: 06/12/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Nursing, being a profession in health, aims to improve the quality of the response to patients' demands, which have repercussions on the attitudes, behaviors and performance of nurses. BACKGROUND The aim of the study was to evaluate the relationships among the nursing practice environment, nurse-patient interactions and patients' satisfaction with nursing care in a hospital context. METHODS The study applied a descriptive analysis. Based on the initial exploration of the data, we decided to perform a simple linear regression of the dimensions of the scales. RESULTS The latent variables and interactions between the different dimensions of the three constructs (the nursing practice environment (PES-NWI), nurse-patient interactions (NPIS-22-PT) and patients' satisfaction in the hospital context (SAPSNC-18)) were submitted to confirmatory analysis. The model was statistically significant, with a good fit with the data (χ2/gl = 128.6/41 (0.000); GFI = 0.900; AGFI = 0.831; TLI = 0.910; CFI = 0.907; RMSEA = 0.102). CONCLUSIONS The study showed favorable rates of overall satisfaction on the part of patients, such as the nurses' skills in dealing with their illness/health situation, ability to solve problems in a timely manner, responsiveness to patients' needs and technical competence.
Collapse
Affiliation(s)
- Paula Agostinho
- Unidade Local de Saúde de Castelo Branco, 6000-085 Castelo Branco, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| | - Teresa Potra
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| | - Pedro Lucas
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| | - Filomena Gaspar
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Escola Superior de Enfermagem de Lisboa, 1600-190 Lisbon, Portugal
| |
Collapse
|
10
|
Shi XP, Dychangco MEA, Yang XM, Olivar JJR. Development and Validation of the Missed Nursing Care Tool for Pre-Operative Patients with Lung Cancer in China. Patient Prefer Adherence 2023; 17:1451-1465. [PMID: 37350778 PMCID: PMC10284153 DOI: 10.2147/ppa.s413585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Current research suggests that missed nursing care is widespread in preoperative lung cancer patients in China, and preoperative airway management nursing care for lung cancer patients is not standardized. Missed nursing care for preoperative lung cancer patients, on the other hand, is rarely investigated, particularly from the patient's perspective. This study aimed to develop and validate the MISSCARE Survey for pre-operative patients with lung cancer in China. Methods This study generated the preliminary draft of the MISSCARE Survey - Lung Cancer Patient (MS-LCP) and tested its reliability and stability through three rounds of lung cancer resection (494, 50, and 309 cases, respectively). 20 patients and 6 experts determined the face and content validity. EFA and CFA assessed construct and convergent validity. Internal consistency, including Cronbach's alpha, Spearman-Brown reliability, and re-test reliability, was also examined. Results The scale contained 15 items, including specific care, communicative care, timely care, and basic care. KMO was 0.932 (> 0.6), and Bartlett's Test of Sphericity showed P = 0.000 (<0.05). The attribution factor's item loads ranged from 0.765 to 0.853, accounting for 82.20% of the variation. The scale's Cronbach's alpha, Spearman-Brown, and retest reliability were 0.945, 0.879, and 0.824. CFA showed goodness of fit (RMSEA = 0.021, χ2/df = 1.138, GFI = 0.900, AGFI = 0.945, CFI = 0.996, NFI = 0.967, IFI = 0.996). For each dimension, AVE ranged from 0.555 to 0.717 (>0.50) and CR from 0.861 to 0.904 (>0.70). Conclusion The MS-LCP was reliable and valid in this study, making it appropriate for the Chinese lung cancer patient population. This tool is more objective in its presentation of missed nursing care, assisting nursing staff in optimizing nursing procedures before surgery, increasing the implementation of higher-quality tumor care, and promoting the recovery of lung cancer surgery patients.
Collapse
Affiliation(s)
- Xin-ping Shi
- The Nursing Department, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Ma Encarnacion A Dychangco
- Paulinian Leadership Academy, University Research Council, St Paul University Manila, Manila, Philippine
| | - Xu-ming Yang
- Operating Room, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | | |
Collapse
|
11
|
Cho H, Han K, Baek H, Ju J. Translations and psychometric validation of the Korean version of the Nursing Teamwork Survey. Res Nurs Health 2023; 46:242-250. [PMID: 36694925 DOI: 10.1002/nur.22297] [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: 08/02/2022] [Revised: 01/04/2023] [Accepted: 01/16/2023] [Indexed: 01/26/2023]
Abstract
Enhancing nursing teamwork benefits both patients and nurses. The Nursing Teamwork Survey is a reliable, valid tool to evaluate nursing teamwork. This study was conducted to translate and psychometrically validate the Nursing Teamwork Survey for nurses in Korea. In Phase 1, the Nursing Teamwork Survey was translated into Korean using forward and backward translations. Content and face validity were determined using expert review and pilot testing, respectively. In Phase 2, we evaluated construct and convergent validity and internal consistency, and test-retest reliability. We used survey data from 1119 hospital nursing staff; 98 of whom completed the Korean version of the Nursing Teamwork Survey after 2 weeks. Confirmatory factor analysis showed an acceptable fit (χ2 /df ratio = 3.96, root mean square error of approximation = 0.05, standardized root mean square residual = 0.05, comparative fit index = 0.91, and Tucker-Lewis index = 0.90) with good internal consistency (Cronbach's α = 0.76-93) and test-retest reliability (rs = 0.63-0.83). Convergent validity was supported by the correlation between the subscales of the Korean version of the Nursing Teamwork Survey and the Teamwork Within Units subscale of the Hospital Survey on Patient Safety Culture (rs = 0.45-0.69, ps < 0.01). These findings indicate that the Korean version of the Nursing Teamwork Survey is a reliable and valid measurement for assessing nursing teamwork. The Korean version of the Nursing Teamwork Survey can inform management strategies to promote nursing teamwork and improve patient safety and nurses' well-being.
Collapse
Affiliation(s)
- Hyeonmi Cho
- Chung-Ang University College of Nursing, Seoul, South Korea
| | - Kihye Han
- Chung-Ang University College of Nursing, Seoul, South Korea
| | - Hyang Baek
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Jieun Ju
- Chung-Ang University Graduate School Department of Nursing, Seoul, South Korea
| |
Collapse
|
12
|
Beiboer C, Andela R, Hafsteinsdóttir TB, Weldam S, Holtrop T, van der Cingel M. Teamwork, clinical leadership skills and environmental factors that influence missed nursing care - A qualitative study on hospital wards. Nurse Educ Pract 2023; 68:103603. [PMID: 36924665 DOI: 10.1016/j.nepr.2023.103603] [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: 10/19/2022] [Revised: 02/10/2023] [Accepted: 02/28/2023] [Indexed: 03/12/2023]
Abstract
AIM To explore how nursing teams in clinical inpatient nursing hospital wards perform teamwork to prevent or reduce missed nursing care and how teamwork is influenced by clinical leadership skills and environmental factors. BACKGROUND Earlier studies on missed nursing care identified teamwork and leadership skills as promising factors in inpatient care that can positively influence quality of care and reduce missed nursing care. The effective use of teamwork in hospitals requires understanding what it is, how it is performed by nursing teams and how it is influenced by clinical leadership skills and environmental factors. DESIGN A qualitative exploratory study was undertaken between January and March 2021. METHODS A total of 16 registered nurses who worked on various hospital wards, participated in three online focus groups. Data were analyzed with thematic analysis according to Braun and Clarke. RESULTS Thematic analysis revealed four themes. First, nurses perform teamwork and clinical leadership skills in various ways. Some nurses work in pairs and have common goals, while other nurses work individually. This influences teamwork. Second, nurses are informal teachers, visible in teaching and learning from each other, contributing in constructive teamwork. Third, senior nurses are seen as informal leaders, forming connection between nursing wards and formal leaders, resulting in awareness of each other and the progress of patientcare. Finally, environmental factors influence the performance of teamwork. CONCLUSIONS Results of this study show how knowledge regarding missed nursing care can be increased. Results can be used for developing training programs and embedding education in practice aimed at constructive teamwork, clinical leadership skills and missed nursing care.
Collapse
Affiliation(s)
| | - Richtsje Andela
- Medical Centre Leeuwarden, the Netherlands; University of applied sciences/Medical Centre Leeuwarden, the Netherlands.
| | | | | | - Tjitske Holtrop
- Medical Centre Leeuwarden, the Netherlands; University of applied sciences/Medical Centre Leeuwarden, the Netherlands.
| | | |
Collapse
|
13
|
Zou Y, Zhai J, Wang X, Wan X, Wang X, Wang H, Zhang J, Guo J, Li Q. Effects of obstetric critical care simulation training on core competency and learning experience of midwives: A pilot quasi-experimental study. Nurse Educ Pract 2023; 69:103612. [PMID: 37087949 DOI: 10.1016/j.nepr.2023.103612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/03/2023] [Accepted: 03/11/2023] [Indexed: 04/09/2023]
Abstract
AIM This study aimed to investigate the effects of maternal critical care simulation training on the core competency and satisfaction of midwives in China. BACKGROUND Midwives play an important role during the peripartum period. Simulation-based training could be an effective tool in improving the core competency of midwives when managing critical obstetric illnesses. DESIGN A pilot pre- and post-course, quasi-experimental study in China. METHOD In July 2022, 82 midwives completed a 2-day obstetric critical care simulation training and survey. Core competency was evaluated by a comprehensive score system, including response ability, communication ability, site control ability, critical thinking ability, team cooperation ability, forward-thinking ability, midwifery specialty ability, and error correction ability. We used the Simulation Effectiveness Tool-Modified (SET-M) to evaluate the learning experience and satisfaction. Descriptive analysis, McNemar χ2 test, and subject content analysis were used for data analysis. RESULTS After the training, the core competency scores showed significant improvements in the case scenarios simulating shoulder dystocia, amniotic fluid embolism, and eclampsia (P < 0.05) but not postpartum hemorrhage (P > 0.05). The scores evaluated by the SET-M were all above 2.5 points. Some midwives preferred extended course duration, expanded course materials, and more active involvement in the simulation exercises. The midwives were generally highly satisfied with the training, but some expressed certain negative emotions, such as anxiety and nervousness. CONCLUSION The high quality of scientifically constructed and implemented obstetric critical care simulation training courses could improve the core competency and satisfaction of midwives. Appropriate preparation and professional simulation teachers are required to reduce negative emotions and improve learning outcomes and experience.
Collapse
|
14
|
Bragadóttir H, Kalisch BJ, Flygenring BG, Tryggvadóttir GB. The Relationship of Nursing Teamwork and Job Satisfaction in Hospitals. SAGE Open Nurs 2023; 9:23779608231175027. [PMID: 37214231 PMCID: PMC10192802 DOI: 10.1177/23779608231175027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/19/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Introduction Teamwork is identified as a key contributor to patient safety and good teamwork is recognized as one of the presumptions of healthy work environment in nursing. The importance of job satisfaction in nursing has repeatedly been confirmed, but only recently has the association of job satisfaction and nursing teamwork been identified. Objective To identify the level of nursing teamwork in hospitals in Iceland and its relationship with job satisfaction. Methods This was a quantitative descriptive cross-sectional study. Data were collected with the Nursing Teamwork Survey administered to nursing staff in medical, surgical, and intensive care units in hospitals in Iceland. This study is based on data from 567 participants. Results A logistic regression analysis indicated that work experience on current unit and perceived staffing adequacy contributes to job satisfaction and when controlling for unit type, role, experience on current unit and staffing adequacy, those reporting better teamwork are significantly more likely to be satisfied with their current position. With an additional unit for overall nursing teamwork, participants are almost five times likelier to be satisfied with their current position. Conclusion Study findings show that there is a significant relationship between nursing teamwork and job satisfaction. The findings of this study confirm the importance of adequate staffing and good teamwork for nurses' job satisfaction. Staffing however, will remain the most challenging part of the equation as lack of nursing staff is foreseen globally in the coming decades turning the spotlight to teamwork. All stakeholders, including clinical nurse leaders, administrators, and instructors, need to emphasize on strengthening nursing teamwork. Good teamwork with increased job satisfaction may prevent turnover and shortage of nurses, an issue expected to grow during and following the COVID-19 pandemic. Facilitating good teamwork should be one of the priorities of every nurse leader.
Collapse
Affiliation(s)
- Helga Bragadóttir
- Faculty of Nursing and Midwifery,
University of Iceland, Eirberg, Reykjavik, Iceland
- Landspitali University
Hospital, Hringbraut, Reykjavik, Iceland
| | | | - Birna G. Flygenring
- Faculty of Nursing and Midwifery,
University of Iceland, Eirberg, Reykjavik, Iceland
| | | |
Collapse
|
15
|
Huang J, Qi H, Zhu Y, Zhang M. Factors Influencing the Initiative Behavior of Intensive Care Unit Nurses toward End-of-Life Decision Making: A Cross-Sectional Study. J Palliat Med 2022; 25:1802-1809. [PMID: 35749724 DOI: 10.1089/jpm.2021.0640] [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: 01/04/2023] Open
Abstract
Background: Although the importance of intensive care unit (ICU) nurse initiative in end-of-life (EOL) decision making has been confirmed, there are few studies on the nurses' initiative in EOL situations. Objectives: To explore the role and mechanism of facilitators/barriers and perceived stress on the behavior of ICU nurses that initiate EOL decision making (i.e., initiative behavior). Design: This research adopted a cross-sectional descriptive design. Setting/Participants: A questionnaire composed of demographics, facilitators/barriers scale, perceived stress scale, and initiative behavior for EOL decision-making scale was used for registered ICU nurses in five tertiary general hospitals in Zhejiang Province, China. Results: The average score of the EOL decision initiative behavior was 5.54 on a range of 2-10. The results of correlation analysis indicated that the facilitators promote the initiative behavior, whereas the barriers interfere with initiative behavior. Facilitators/barriers in the EOL decision-making process significantly predicted the initiative behavior of ICU nurses in decision making (β = 0.698, p < 0.001). Facilitators/barriers had a significant indirect effect on the initiative behavior of ICU nurses through perceived stress. The 95% confidence interval was (-0.327 to -0.031), and the mediating effect of perceived stress accounted for 6.31% of the total effect. Conclusion: In the EOL context, the decision initiative of ICU nurses was at a medium level. Medical managers should implement intervention strategies based on the path that affects the initiative behavior of ICU nurses to reduce barriers and stress level in the decision-making process. That is, they should improve inter-team collaboration, nurse-patient communication, clarity of role responsibilities, and emotional support in dying situations to increase initiative and participation of ICU nurses in decision making.
Collapse
Affiliation(s)
- Jingying Huang
- Postanesthesia Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Haiou Qi
- Nursing Department, and Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Yiting Zhu
- Postanesthesia Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| | - Minyan Zhang
- Intensive Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, P.R. China
| |
Collapse
|
16
|
An Overview of Missed Nursing Care and Its Predictors in Saudi Arabia: A Cross-Sectional Study. Nurs Res Pract 2022; 2022:4971890. [PMID: 36278115 PMCID: PMC9581685 DOI: 10.1155/2022/4971890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nursing care is holistic, and missing any aspect of care can be critical to patients' health. However, due to the complex and intense nature of the nursing practice, nurses have to unintentionally prioritize some activities, forcing them to omit some aspects of nursing care. Aim To explore the dimensions of missed nursing care and its predictors within the Saudi Arabian healthcare system. Methods Quantitative, cross-sectional study used the MISSCARE survey by utilizing nonprobability convenience sampling to collect the data of 604 staff nurses working in inpatient wards in Jazan, Saudi Arabia. Results The overall mean of missed nursing care is (m = 1.37, SD = 0.45). Missed nursing care activities were mostly failure to attend interdisciplinary care conferences (m = 1.66, SD = 0.96) and patient ambulation thrice a day (m = 1.63, SD = 0.97). Missed nursing care was mainly caused by human resource shortage (m = 3.53, SD = 0.88). Missed nursing care is predicted by the turnover intention (B = 2.380, t = 3.829, p < 001) and job satisfaction (B = −0.864, t = −4.788, p < 001). Conclusion Although missed nursing care is evident in Saudi Arabia, it is significantly lower than the international rates, and it is mainly caused by labor resource shortage which directly influences nurses' job satisfaction and intention to leave. Optimizing the recruitment process, resource allocation and effective nurses' retention programs are proposed solutions that may be beneficial to mitigate missed nursing care.
Collapse
|
17
|
He M, Zhu X, Dong Y, Zhang S, Fang S, Wang W, Zhang M, Sun J. Exploring the role of communication in missed nursing care: A systematic review. J Adv Nurs 2022; 78:4019-4033. [PMID: 36097637 DOI: 10.1111/jan.15444] [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: 05/24/2022] [Revised: 08/11/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022]
Abstract
AIMS To systematically review the literature on relationships between communication issues and missed nursing care. DESIGN Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. DATA SOURCES EMBASE, Web of Science, CINAHL, PubMed and Cochrane databases were comprehensively searched from inception to December 2021. REVIEW METHODS Screening, data extraction and initial quality assessment were conducted independently by two reviewers. The JBI quality assessment tool was used for study appraisal and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Discrepancies were settled by consulting a third researcher. RESULTS A total of 18 articles were included. Missed nursing care was common and the status of communication was not optimistic in clinical. Nurses' sociodemographic characteristics and work environment both influenced missed nursing care and communication. Intrateam communication included three parts: doctors-nurses communication, nurses-nurses communication and nurses-patients communication, poor intrateam communication could contribute to missed nursing care. There was an interaction between missed nursing care and communication. CONCLUSION Promoting efficient intrateam communication, to acknowledge the importance of communication factors in reducing the incidence of missed nursing care in clinics is required. Future research can explore the impact of the internal dimension of communication on missed nursing care and consider interventions aimed at nurses' effective communication. IMPACT What problem did the study address? This study offers new evidence that the impact of intrateam communication on missed nursing care. What were the main findings? Effective intrateam communication can reduce the incidence of missed nursing care, there is mutual influence between communication and missed nursing care. Where and on whom will the research have an impact? Policymakers can provide positive interventions on communication problems in different populations (e.g. nurses-patients, nurses-nurses and doctors-nurses) to provide high-quality patient care.
Collapse
Affiliation(s)
- Meng He
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Xiangning Zhu
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Yueyang Dong
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Shuang Zhang
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Shuyan Fang
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Wenxia Wang
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Mengting Zhang
- School of Nursing, Jilin University, Changchun, People's Republic of China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, People's Republic of China
| |
Collapse
|
18
|
Qureshi SM, Purdy N, Greig MA, Kelly H, vanDeursen A, Neumann WP. Developing a simulation tool to quantify biomechanical load and quality of care in nursing. ERGONOMICS 2022:1-18. [PMID: 35975403 DOI: 10.1080/00140139.2022.2113921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Nursing is a high musculoskeletal disorder (MSD) risk job with high workload demands. This study combines Digital Human Modelling (DHM) and Discrete Event Simulation (DES) to address the need for tools to better manage MSD risk. This novel approach quantifies physical-workload, work-performance, and quality-of-care, in response to varying geographical patient-bed assignments, patient-acuity levels, and nurse-patient ratios. Lumbar loads for 86 care-delivery tasks in an acute care hospital unit were used as inputs in a DES model of the care-delivery process, creating a shift-long time trace of the biomechanical load. Peak L4/L5 compression and moment were 3574 N and 111.58 Nm, respectively. This study reports trade-offs in all three experiments: (i) increasing geographical patient-bed assignment distance decreased L4/L5 compression (8.8%); (ii) increased patient-acuity decreased L4/L5 moment (4%); (iii) Increased nurse-patient ratio decreased L4/L5 compression (10%) and moment (17%). However, in all experiments, Quality of care indicators deteriorated (20, 19, and 29%, respectively). Practitioner Summary: This research has the potential to support decision-makers by developing a simulation tool that quantifies the impact of varying operational and design-policies in terms of biomechanical-load and quality of care. The demonstrator-model reports: as geographical patient-bed distance, patient-acuity levels, and nurse-patient ratios increase, biomechanical-load reduces, and quality of care deteriorates.
Collapse
Affiliation(s)
- Sadeem Munawar Qureshi
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | - Nancy Purdy
- Daphne Cockwell School of Nursing, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | - Michael A Greig
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| | | | | | - W Patrick Neumann
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering, Toronto Metropolitan University (Formerly Ryerson University), Toronto, Canada
| |
Collapse
|
19
|
Alfuqaha OA, Alhalaiqa FN, Alqurneh MK, Ayed A. Missed nursing care before and during the COVID-19 pandemic: A comparative cross-sectional study. Int Nurs Rev 2022; 70:100-110. [PMID: 35947610 PMCID: PMC9538371 DOI: 10.1111/inr.12795] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/22/2022] [Indexed: 11/28/2022]
Abstract
AIM This study aimed to compare perception of nurses about missed care for the patients before and during the coronavirus disease 2019 (COVID-19) in Jordan. It also examined how nurses differed in terms of the type of missed care and the factors that contributed to it before and during the COVID-19 pandemic. Additionally, socio-demographic factors, including gender, educational level, length of clinical experience, work position, age, and type of shift, were examined to evaluate their association with missed nursing care. BACKGROUND Missed nursing care refers to omission of any aspect of required patient care. Missed care lowers patient satisfaction and also leads to adverse hospital outcomes. METHODS We adopted a cross-sectional design among 260 nurses working in medical/surgical wards and intensive care units. Views of 130 nurses before COVID-19 were compared with views of 130 nurses during the COVID-19 pandemic. We used the Arabic version of the MISSCARE survey. Data were collected between November 2019 and May 2020. RESULTS During COVID-19, nurses had significantly higher satisfaction levels and lower levels of absence and intention to leave than nurses before the COVID-19 pandemic. Differences were observed between nurses' perceptions of missed care before and during the COVID-19 pandemic. It was observed that missed nursing care increased during COVID-19. The inadequate number of staff nurses was the main reason for missed care activities among both groups. Additionally, age and shift type were significantly associated with an increased reason for missed nursing care among both groups. CONCLUSION AND IMPLICATIONS FOR NURSING Nurses reported higher satisfaction levels and fewer absences and planned departures during this period. Nurse managers should pay attention by maintaining high satisfaction levels and formulating appropriate policies to reduce missed care levels and thus improve patient care quality.
Collapse
Affiliation(s)
- Othman A. Alfuqaha
- Department of NursingJordan University HospitalThe University of JordanAmman11942Jordan
| | | | - Mohammad K. Alqurneh
- Department of NursingJordan University HospitalThe University of JordanAmman11942Jordan
| | - Ahmad Ayed
- Faculty of NursingArab American UniversityJeninPalestine
| |
Collapse
|
20
|
Hernández-Corral S, Serván-Mori E, Benítez-Chavira LA, Nigenda G, Zárate-Grajales RA. Missed nursing care in highly specialized hospitals: A Mexican case study. Int J Health Plann Manage 2022; 37:2997-3005. [PMID: 35723665 DOI: 10.1002/hpm.3501] [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: 12/29/2021] [Revised: 04/16/2022] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To assess the status of missed nursing care and the reasons for its occurrence in a highly specialised public hospital in Mexico. MATERIALS AND METHODS An observational cross-sectional analysis with data collected from January to June 2019 at the National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra in Mexico City. We assessed missed care and its causes by conducting the MISSCARE survey among 116 nursing professionals selected from a population of 162 nurses. This work presents the estimated rates of missed care-overall and broken down into its four dimensions-as well as the reasons for its occurrence, namely limited labour resources, inadequate material resources and communication problems among work teams. RESULTS The overall score for missed care was 16% (95% CI: 11.84%-20.15%), with the following rates by dimension: 19.48% for basic care, 14.66% for individual needs, 6.47% for patient education and discharge planning, and 4.31% for continuous patient assessment. The main reason cited for missed care was inadequate material resources, followed by limited labour resources and communication problems among work teams. CONCLUSION Basic care and individual needs interventions were the most frequently omitted services, primarily because of inadequate material resources, limited labour resources and communication problems among work teams. An increase in the frequency of missed care can be expected in light of the high demand for health services, particularly as regards labour and material resources, imposed by the SARS-CoV-2 pandemic.
Collapse
Affiliation(s)
| | - Edson Serván-Mori
- Center for Health Systems and Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Luis A Benítez-Chavira
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
| | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosa A Zárate-Grajales
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
| |
Collapse
|
21
|
Chiappinotto S, Papastavrou E, Efstathiou G, Andreou P, Stemmer R, Ströhm C, Schubert M, de Wolf-Linder S, Longhini J, Palese A. Antecedents of unfinished nursing care: a systematic review of the literature. BMC Nurs 2022; 21:137. [PMID: 35698217 PMCID: PMC9195215 DOI: 10.1186/s12912-022-00890-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Unfinished Nursing Care (UNC) concept, that express the condition when nurses are forced to delay or omit required nursing care, has been largely investigated as tasks left undone, missed care, and implicit rationing of nursing care. However, no summary of the available evidence regarding UNC antecedents has been published. The aim of this study is to identify and summarise antecedents of UNC as documented in primary studies to date. METHODS A systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. MEDLINE, CINAHL, SCOPUS, and PROSPERO databases were searched for quantitative studies reporting the relationships between antecedents and UNC published after 2004 up to 21 January 2020. The reference lists of secondary studies have been scrutinised to identify additional studies. Two reviewers independently identified studies and evaluated them for their eligibility and disagreements were resolved by the research team. The quality appraisal was based on the Joanna Briggs Institute Critical Appraisal tools, according to the study designs. A data extraction grid was piloted and then used to extract data. The antecedents that emerged were thematically categorised with an inductive approach. RESULTS Fifty-eight studies were included; among them, 54 were cross-sectional, three were cohort studies, and one was a quasi-experimental study. They were conducted mainly in the United States and in hospital settings. The UNC antecedents have been investigated to date at the (a) unit (e.g., workloads, non-nursing tasks), (b) nurse (e.g., age, gender), and (c) patient levels (clinical instability). CONCLUSIONS At the unit level, it is highly recommended to provide an adequate staff level, strategies to deal with unpredictable workloads, and to promote good practice environments to reduce or minimise UNC. By contrast, at the nurse and patient levels, there were no clear trends regarding modifiable factors that could decrease the occurrence of UNC. The map of antecedents that emerged can be used to design interventional studies aimed at changing research from merely descriptive to that which evaluates the effectiveness of interventions.
Collapse
Affiliation(s)
| | - Evridiki Papastavrou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Georgios Efstathiou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus.,Nursing Services, Ministry of Health, Nicosia, Cyprus
| | | | | | | | - Maria Schubert
- School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland
| | - Susanne de Wolf-Linder
- School of Health Professions, Zurich University of Applied Science, Winterthur, Switzerland
| | - Jessica Longhini
- Department of Medical Sciences, University of Udine, Udine, Italy
| | - Alvisa Palese
- Department of Medical Sciences, University of Udine, Udine, Italy.
| |
Collapse
|
22
|
Janatolmakan M, Khatony A. Explaining the experiences of nurses regarding strategies to prevent missed nursing care: A Qualitative Study. J Nurs Manag 2022; 30:2054-2061. [PMID: 35510342 DOI: 10.1111/jonm.13662] [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: 11/29/2021] [Revised: 04/26/2022] [Accepted: 04/29/2022] [Indexed: 11/30/2022]
Abstract
AIM To describe the experiences of nurses regarding strategies to prevent missed nursing care. BACKGROUND One of the global challenges is missed nursing care, which includes missed or delayed care. This problem puts patients' clinical outcome at risk, so understanding nurses' experiences of how to prevent or reduce it can help the healthcare policymakers. METHOD In this qualitative descriptive study, 14 nurses were selected by purposive sampling. In-depth semi-structured interviews were conducted to collect data. The Graneheim and Lundman's approach of qualitative content analysis was used for data analysis. MAXQDA (version 10) software was used for data management. RESULTS The extracted codes were summarized into seven categories and one theme. The categories included "empowering nurses", "manpower supply", "supervision", "specializing the activities", "providing resources and facilities", "encouraging teamwork", and "resolving dissatisfaction. " The main theme was " missed nursing care prevention strategies". CONCLUSION The frequency of missed nursing care can be reduced or prevented using management strategies such as paying attention to nurses 'empowerment, increasing nurses' job satisfaction, normalizing nurses' salaries, providing equipment and facilities, and monitoring nurses' performance. Experimental studies are recommended to evaluate the effectiveness of these strategies. Implications for nursing management Nursing managers can take steps such as workplace improvement, reducing nurses' workload, and empowering nurses to reduce or eliminate missed care.
Collapse
Affiliation(s)
- Maryam Janatolmakan
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Khatony
- Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.,Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| |
Collapse
|
23
|
Taskiran Eskici G, Baykal U. Frequency, reasons, correlates and predictors of missed nursing care in Turkey: A multi-hospital cross-sectional study. Int J Nurs Pract 2022; 28:e13050. [PMID: 35294994 DOI: 10.1111/ijn.13050] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 02/20/2022] [Accepted: 02/27/2022] [Indexed: 11/29/2022]
Abstract
AIM We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey. METHODS This descriptive and cross-sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey-Turkish and the MISSCARE Survey-Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data. RESULTS The total occurrence of missed nursing care was 2.93 (on a scale of 1.00-4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient-nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care. CONCLUSIONS The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient-nurse ratio and nursing teamwork to reduce the incidence of missed nursing care.
Collapse
Affiliation(s)
- Gulcan Taskiran Eskici
- Department of Nursing Administration, Faculty of Health Sciences, Ondokuz Mayis University, Samsun, Turkey
| | - Ulku Baykal
- Department of Nursing Administration, Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpasa, Istanbul, Turkey
| |
Collapse
|
24
|
Mills SL, Duddle M. Missed nursing care in Australia: Exploring the contributing factors. Collegian 2022. [DOI: 10.1016/j.colegn.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
25
|
Factors Contributing to Rationed Nursing Care in the Slovak Republic-A Secondary Analysis of Quantitative Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020702. [PMID: 35055524 PMCID: PMC8775605 DOI: 10.3390/ijerph19020702] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/01/2022] [Accepted: 01/07/2022] [Indexed: 02/04/2023]
Abstract
Rationed nursing care is a significant problem in healthcare facilities worldwide. Awareness of contributing factors to rationed care might support the development and implementation of strategies for reducing this phenomenon from clinical practice. The study examined the association between selected hospital, unit, and staff variables and the prevalence of rationed nursing care. Secondary analysis of cross-sectional data collected between December 2017 and July 2018 from 895 registered nurses in seven acute care hospitals in the Slovak Republic was performed. Data were collected using the questionnaire Perceived Implicit Rationing of Nursing and analyzed by descriptive and inferential statistics in the statistical program SPSS 25.0. Statistically significant associations were found between rationed nursing care and unit type, education, shift type, nurses' experience in the current unit, overtime hours, missed shifts, intention to leave the position, perceived staff adequacy, quality of patient care, and job satisfaction. Differences in rating rationed nursing care, quality of patient care, and job satisfaction were identified based on hospital type. Together with top hospital management, nurse managers should develop targeted interventions focusing on mitigating rationed nursing care from the clinical practice with a focus placed on university hospitals. Quality and safe care might be ensured through constant monitoring of the quality of patient care and job satisfaction of nurses as these factors significantly predicted the estimates of rationed nursing care.
Collapse
|
26
|
Jomaa C, Dubois CA, Caron I, Prud'Homme A. Staffing, teamwork and scope of practice: Analysis of the association with patient safety in the context of rehabilitation. J Adv Nurs 2021; 78:2015-2029. [PMID: 34841549 PMCID: PMC9300032 DOI: 10.1111/jan.15112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
Aims To describe the organization of nursing services (staffing, scope of practice, teamwork) and its association with medication errors and falls, in rehabilitation units. Background The healthcare system is greatly impacted by the ageing population and the complexity of care associated with chronic diseases. It is therefore necessary to have enough staff who are using their full scope of practice and who are operating in a favourable working environment. However, these conditions are not always met, which can lead to threats to patient safety. Design A correlational descriptive study. Methods Staffing data and reported safety incidents were collected by shift from 01 October 2019 until 15 January 2020 in five rehabilitation units. In addition, a total of 75 nursing staff members responded to a missed care and teamwork survey. Descriptive analysis and logistic regression analysis were performed. Results The mean staff hours per patient shift was 1.39 (SD = 0.60). The teams reported a global missed care score as ‘rarely missed’ at 1.14 (SD = 0.07) and a moderate teamwork score at 3.36 (SD = 0.58) on a five‐point scale. The safety incidents decreased 10‐fold with a predominance of bachelor compared with technician nurses and decreased by 67% when there was an increase of 1 h of care per patient shift. Conclusions This study showed that the organization of nursing services in the observed rehabilitation units is characterized by a moderate staffing intensity, a moderate perception of teamwork level and a relatively low level of missed care. It indicated the key role of the staffing in reducing the risk of occurrence of safety incidents. Future research specific to rehabilitation hospitals are greatly needed to improve patient outcomes in this setting. Impact Nurse Managers should consider all the aspects of the organization of nursing services (staffing, scope of practice and teamwork) in their efforts to improve patient safety in rehabilitation settings. A central finding of this study is that the staffing intensity, the proportion of bachelor prepared nurses and the proportion of agency staff were positively associated with a reduction of safety incidents.
Collapse
Affiliation(s)
- Carla Jomaa
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.,Centre Intégré Universitaire de Santé et des Services Sociaux du Centre-Ouest de l'île de Montréal, Montreal, QC, Canada
| | - Carl-Ardy Dubois
- School of Public Health, University of Montreal (ESPUM), Montreal, QC, Canada
| | - Isabelle Caron
- Centre Intégré Universitaire de Santé et des Services Sociaux du Centre-Ouest de l'île de Montréal, Montreal, QC, Canada
| | | |
Collapse
|
27
|
Roche MA, Glover S, Luo X, Joyce M, Rossiter C. Extending the role of nursing assistants in mental health inpatient settings: A multi-method study. Int J Ment Health Nurs 2021; 30:1070-1079. [PMID: 33742529 DOI: 10.1111/inm.12859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
With continued growth in the demand for nursing care, many organizations have incorporated nursing assistants into the acute care workforce. However, role descriptions are often generic and do not provide clarity in specialist areas such as mental health inpatient settings. Issues have been noted regarding the role of assistants, delegation, and their integration with the nursing team. This study extended an existing set of care activities and explored the perceptions of nursing assistants and registered nurses regarding these activities. A modified Delphi approach added 14 new care activities for nursing assistants. A follow-up survey found significant differences between nursing assistants and registered nurses regarding utilization of the activities, delegation, teamwork, and role clarity. Future research must incorporate the perspectives of those with lived experience of mental health issues, and develop an understanding of the interactions between nursing assistant care activities and other factors such as local supports, skillmix, and the practice environment, as these may impact how an organization can introduce nursing assistants to specialty areas while maintaining consumer and staff safety.
Collapse
Affiliation(s)
- Michael A Roche
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia.,School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Suzanne Glover
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Xiaoou Luo
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Mark Joyce
- Mental Health Drug and Alcohol Services, Northern Sydney Local Health District, North Ryde, New South Wales, Australia
| | - Chris Rossiter
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, New South Wales, Australia
| |
Collapse
|
28
|
Larsson IM, Aronsson A, Norén K, Wallin E. Healthcare workers' structured daily reflection on patient safety, workload and work environment in intensive care. A descriptive retrospective study. Intensive Crit Care Nurs 2021; 68:103122. [PMID: 34362657 DOI: 10.1016/j.iccn.2021.103122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 06/22/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To describe the results of use of structured daily reflection assessments among healthcare workers at an intensive care unit over the course of one year. METHODS In this descriptive retrospective study, data were analysed both quantitatively and qualitatively. The data encompassed 1095 work shifts, evaluated by healthcare workers at an intensive care unit using a structured daily reflection instrument. The areas evaluated were patient safety, workload and work environment, and free-text comments were possible. FINDINGS The results showed that 36% (n = 395) of work shifts, most of them daytime shifts (44%; n = 161), were affected. Workload was the area that affected most work shifts (29%; n = 309). Missed nursing care, complex care and inaccurate communication impacted patient safety, while patient care, multitasking and working conditions affected workload. Work environment was impacted by organisational factors, environment, lack of control and moral stress. CONCLUSION Using daily reflection among healthcare workers in the intensive care unit illuminated areas that affect patient safety, workload, and work environment. The importance of communication and collaboration and how they can impact patient safety, workload, and the work environment were highlighted by the team.
Collapse
Affiliation(s)
- Ing-Marie Larsson
- Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, SE-751 85 Uppsala, Sweden; Department of Intensive Care, University Hospital, Uppsala, Sweden.
| | - Anna Aronsson
- Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, SE-751 85 Uppsala, Sweden; Department of Intensive Care, University Hospital, Uppsala, Sweden
| | - Karin Norén
- Department of Intensive Care, University Hospital, Uppsala, Sweden
| | - Ewa Wallin
- Department of Surgical Sciences, Anaesthesiology & Intensive Care, Uppsala University, SE-751 85 Uppsala, Sweden; Department of Intensive Care, University Hospital, Uppsala, Sweden
| |
Collapse
|
29
|
Hammad M, Guirguis W, Mosallam R. Missed nursing care, non-nursing tasks, staffing adequacy, and job satisfaction among nurses in a teaching hospital in Egypt. J Egypt Public Health Assoc 2021; 96:22. [PMID: 34283331 PMCID: PMC8292524 DOI: 10.1186/s42506-021-00083-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 06/22/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Missed nursing care (MNC) has been linked to patient harm in a growing body of literature. However, this issue is still not adequately investigated in developing countries. The aim of the study is to measure the extent of missed nursing care, to identify its types, and to determine factors contributing to missed nursing care. METHODS A cross-sectional design was used. The study was conducted among 50 units at 1762-beds teaching Hospital in Alexandria that employs 1211 nurses in inpatient areas. A sample of 553 nurses were interviewed using the MISSCARE and the N4CAST survey. The MISSCARE survey measured the amount of missed nursing care (MNC) that was experienced on the last worked shift by each nurse. The N4CAST survey was used to collect data about level of non-nursing work carried out by nurses and the nurses' job satisfaction. RESULTS The overall mean score for the missed nursing care was 2.26 ± 0.96 out of 5, with highest mean score attributed to "Planning" and lowest mean score attributed to "Assessment and Vital Signs" (2.64 and 1.96, respectively). Missed nursing care was significantly associated with number of patients admitted and cared for in the last shift and perceived staffing adequacy. Almost all non-nursing care tasks and most of satisfaction elements showed negative weak correlation with overall missed nursing care. CONCLUSION Missed Nursing Care is common in study hospital which may endanger patient safety. MNC Missed Nursing Care is positively associated with nursing adequacy. There is no association between MNC and neither nurses' job satisfaction nor non-nursing tasks. Nursing leaders should monitor missed nursing care and the environmental and staffing conditions associated with it in order to design strategies to reduce such phenomena.
Collapse
Affiliation(s)
- Marwa Hammad
- Ministry of Health, 97 El-Horeya Road, Qism Bab Sharqi, Wabour Al Meyah, Alexandria Governorate, Egypt
| | - Wafaa Guirguis
- High Institute of Public Health, Alexandria University, 165 El-Horeya Road, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Qism Bab Sharqi, Alexandria Governorate, Egypt
| | - Rasha Mosallam
- High Institute of Public Health, Alexandria University, 165 El-Horeya Road, Al Ibrahimeyah Qebli WA Al Hadrah Bahri, Qism Bab Sharqi, Alexandria Governorate, Egypt.
| |
Collapse
|
30
|
Campbell AR, Kennerly S, Swanson M, Forbes T, Scott ES. Manager's influence on the registered nurse and nursing assistant relational quality and patient safety culture. J Nurs Manag 2021; 29:2423-2432. [PMID: 34272913 DOI: 10.1111/jonm.13426] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/20/2021] [Accepted: 07/15/2021] [Indexed: 11/28/2022]
Abstract
AIMS The purpose of this study is to describe the perceptions of relational quality of the registered nurse and nursing assistant and examine how their view of the manager's influence impacts overall patient safety culture of a unit. BACKGROUND The primary delivery of nursing care within acute care systems uses teams of registered nurses and nursing assistants. METHODS A cross-sectional secondary analysis of data collected in the spring of 2018 using the Agency for Healthcare and Quality Hospital Survey of Patient Safety Culture and a seven-item questionnaire measuring relational quality was conducted. The sample included 1,152 responses. RESULTS The manager influenced overall perceptions of safety regardless of the relational quality between the registered nurse and nursing assistant. CONCLUSIONS This study found manager behaviours that promote patient safety and also influence overall perceptions of patient safety culture regardless of the relational quality between the registered nurse and nursing assistant. IMPLICATIONS FOR NURSING MANAGEMENT Positive registered nurse and nursing assistant relational quality amplifies perceptions of patient safety culture, yet it is the manager's behaviours regarding safety that make the stronger contribution in building a culture of safety.
Collapse
Affiliation(s)
| | - Susan Kennerly
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Melvin Swanson
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Thompson Forbes
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| | - Elaine S Scott
- Department of Nursing, East Carolina University, Greenville, North Carolina, USA
| |
Collapse
|
31
|
Willis E, Brady C. The impact of "missed nursing care" or "care not done" on adults in health care: A rapid review for the Consensus Development Project. Nurs Open 2021; 9:862-871. [PMID: 34132481 PMCID: PMC8859051 DOI: 10.1002/nop2.942] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 04/19/2021] [Accepted: 04/29/2021] [Indexed: 11/16/2022] Open
Abstract
Aim To identify outcomes of missed nursing care for adult patients. Design A five‐stage rapid review process was conducted as follows: refining the question, retrieving relevant studies, determining the studies to be included, organizing the data and synthesizing the results. Methods Papers published between 2010–2020 that focused on the UK, Europe, the USA and Oceania were searched for keywords in the title and abstract in major databases. The articles that identified the impact of missed nursing care on adults in health care were selected. Results Seventeen articles met the criteria. Major impacts of missed care in adult settings were increases in mortality, adverse events and failure to maintain. These same studies also identified a range of causative factors linked to ward environment, inadequate staffing levels and skills mix although are inconclusive. Solutions include continuing education, ward and work re‐design, and appropriate skill level.
Collapse
Affiliation(s)
- Eileen Willis
- College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
| | - Catherine Brady
- Corporate Services, Flinders University, Adelaide, Australia
| |
Collapse
|
32
|
Costello M, Rusell K, Coventry T. Examining the average scores of nursing teamwork subscales in an acute private medical ward. BMC Nurs 2021; 20:84. [PMID: 34059037 PMCID: PMC8166033 DOI: 10.1186/s12912-021-00609-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 05/25/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Healthcare is delivered by multidisciplinary healthcare teams who rely on communication and effective teamwork to ensure safe patient care. Teamwork builds on employee cohesion and reduces medical and nursing errors, resulting in greater patient satisfaction and improved healthcare. Effective teamwork not only improves efficiency and patient safety but leads to a healthier and happier workplace, reducing burnout among healthcare professionals. The purpose of this paper is to describe the findings of a pilot project on an acute medical ward in Western Australia. The aim was to understand the participants perceived level of teamwork to support future work practices and ultimately patient care. METHODS This study used a descriptive survey research method to measure nursing teamwork in a clinical environment. The Nursing Teamwork Survey (NTS) measures the levels of nursing teamwork in acute healthcare facilities. Items for the NTS were generated on theoretical grounds, based on teamwork behaviours, offering a practical explanation of teamwork dynamics. RESULTS The survey incorporated five subscales. The response rate to the survey was 90 % (n = 45) with an overall average result on the survey being (m = 2.97) on a 0-4 Likert scale. The validated NTS has provided participants the opportunity to consider nursing teamwork with regards to their position and perceived responsibilities towards patients and team members. CONCLUSION The findings highlight areas for consolidation and improvement in teamwork. Introducing teambuilding strategies and acting on results of this survey may support enhanced communication and teamwork influencing nursing care and patient outcomes. Findings recommend that activities to improve teamwork and ensuring teambuilding strategies are implemented to improve effective communication in an acute medical care setting would have significant impacts on staff satisfaction.
Collapse
Affiliation(s)
- Martina Costello
- School of Nursing and Midwifery, Edith Cowan University, 270 Joondalup Drive, 6027 Joondalup, Western Australia
| | - Kylie Rusell
- School of Nursing & Midwifery, The University of Notre Dame Australia, 19 Mouat Street, 6160 Fremantle, Western Australia
| | - Tracey Coventry
- School of Nursing & Midwifery, The University of Notre Dame Australia, 19 Mouat Street, 6160 Fremantle, Western Australia
| |
Collapse
|
33
|
Kakemam E, Hajizadeh A, Azarmi M, Zahedi H, Gholizadeh M, Roh YS. Nurses' perception of teamwork and its relationship with the occurrence and reporting of adverse events: A questionnaire survey in teaching hospitals. J Nurs Manag 2021; 29:1189-1198. [PMID: 33480125 DOI: 10.1111/jonm.13257] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/31/2020] [Accepted: 01/15/2021] [Indexed: 11/26/2022]
Abstract
AIMS To identify the levels of teamwork and its relationship with the occurrence and reporting of adverse events among Iranian nurses. BACKGROUND Strengthening teamwork is emphasized worldwide for enhancing quality care and patient safety. METHODS This study applied a cross-sectional survey design. A total of 327 Iranian nurses from eight teaching hospitals participated in a self-administered survey using simple random sampling. The Teamwork Perceptions Questionnaire was used to measure the teamwork. The frequency of occurrence and reporting of adverse events were measured with two questions. Data were analysed using descriptive analyses, independent t tests and logistic regression analysis. RESULTS The mean teamwork score was 3.81 out of 5. Among the nurses, 48.0% had experienced adverse events in the past 6 months and 79.8% reported having an appropriate performance in adverse events reporting. Teamwork was significantly associated with lower occurrences of adverse events and better adverse events reporting. Specifically, nurses with higher situation monitoring (odds ratio (OR) = 0.47), mutual support (OR = 3.18) and team leadership (OR = 2.09) scores were more likely to report adverse events. Nurses with higher situation monitoring scores were less likely to experience the occurrence of adverse events (OR = 0.38). CONCLUSIONS Nurses' perception of teamwork was moderate to high. Teamwork was associated with the occurrence and reporting of adverse events. Further study is needed to identify the effects of teamwork training on the learning outcomes, including teamwork, occurrence and the reporting of adverse events among nurses. IMPLICATIOS FOR NURSING MANAGEMENT Nursing managers should consider multiple educational strategies including structured teamwork training to improve staff nurses' teamwork competency. Administrative initiatives and quality improvement projects are needed to increase nurses' performance in the reporting of adverse events through an accreditation process.
Collapse
Affiliation(s)
- Edris Kakemam
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Hajizadeh
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Azarmi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hamideh Zahedi
- Department of Community Health Nursing, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Gholizadeh
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Young Sook Roh
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| |
Collapse
|
34
|
Zhao Y, Su J, Ma D, Li H, Li Y, Zhang X, Li Z, Sun J. The role of teamwork in the implicit rationing of nursing care: A systematic mixed-methods review. J Nurs Manag 2020; 29:890-904. [PMID: 33306210 DOI: 10.1111/jonm.13231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/30/2020] [Accepted: 12/05/2020] [Indexed: 11/29/2022]
Abstract
AIM To systematically evaluate the role of teamwork in implicit rationing care and how to improve teamwork. BACKGROUND The implicit rationing of nursing leads to adverse effects for both patients and nurses. Therefore, how to reduce it has attracted increasing research attention. How teamwork may be an important factor in reducing implicit rationing care has become a focus of research. METHODS Data between May 2000 and May 2020 were collected from five databases. The study was guided by the framework of a mixed studies review. RESULTS Seventeen studies were chosen for review regarding efficient teamwork to reduce implicit rationing care. The following seven subthemes with positive effects that improve teamwork and reduce implicit rationing care were formed: (a) improving knowledge and skills; (b) promoting effective communication; (c) building mutual trust; (d) reducing turnover intention; (e) reasonable staffing; (f) division of responsibilities; and (g) cultivating team consciousness. CONCLUSIONS Teamwork can decrease implicit care and is influenced by many factors, but the intervention is singular. In the future, teamwork can be further improved to reduce implicit care. IMPLICATIONS FOR NURSING MANAGEMENT With more intervention research in the future, leadership and team-oriented roles can be used to complete all the care needed.
Collapse
Affiliation(s)
- Yingnan Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Jianping Su
- School of Nursing, Jilin University, Changchun, China.,School of Nursing, Xinjiang Medical University, Urumqi Municipality, China
| | - Dongfei Ma
- School of Nursing, Jilin University, Changchun, China
| | - Huanhuan Li
- School of Nursing, Jilin University, Changchun, China
| | - Yijing Li
- School of Nursing, Jilin University, Changchun, China
| | - Xu Zhang
- School of Nursing, Jilin University, Changchun, China
| | - Zehui Li
- School of Nursing, Jilin University, Changchun, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, China
| |
Collapse
|
35
|
Schubert M, Ausserhofer D, Bragadóttir H, Rochefort CM, Bruyneel L, Stemmer R, Andreou P, Leppée M, Palese A. Interventions to prevent or reduce rationing or missed nursing care: A scoping review. J Adv Nurs 2020; 77:550-564. [PMID: 33089553 DOI: 10.1111/jan.14596] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 08/15/2020] [Accepted: 08/27/2020] [Indexed: 11/26/2022]
Abstract
AIMS To collate and synthesize published research on interventions developed and tested to prevent or reduce the rates of rationed or missed nursing care in healthcare institutions. BACKGROUND Rationed and missed nursing care has been widely studied, including its predictors and associations with patient and nurse outcomes. DESIGN Scoping review. DATA SOURCES We searched for eligible studies, published between 1980-2019, in six electronic databases. REVIEW METHODS Researchers independently screened the abstracts of the retrieved studies using the inclusion and exclusion criteria. The decision of whether or not to include any given study was consensus-based. RESULTS The search yielded 1,815 records, of which 13 were included. Three studies reported structural interventions, namely increased nurse staffing and improved nursing teamwork, both resulted in significant reductions in the rates of rationed or missed nursing care. The remaining 10 studies reported on process interventions: four concerned reminders (via technology or designated persons) and seven described interventions to change or optimize the relevant care processes. All 10 process interventions contributed to significant reductions in the rates of missed nursing care. CONCLUSIONS The results of the scoping review indicate that specific interventions can positively influence the performance of a selected nursing care activity, for example fall prevention. There is no evidence of a global reduction of rationed and missed nursing care through these interventions. IMPACT Clinicians, managers and researchers can use the results for adapting and implementing interventions to reduce rationed and missed nursing care.
Collapse
Affiliation(s)
- Maria Schubert
- School of Health Professions, ZHAW - Zurich University of Applied Science, Institute of Nursing, Winterthur, Switzerland
| | - Dietmar Ausserhofer
- Nursing Science, Faculty of Medicine, Department of Public Health, University of Basel, Basel, Switzerland.,Claudiana College of Health-Care Professions, Bolzano, Italy
| | - Helga Bragadóttir
- Faculty of Nursing, School of Health Sciences and Landspítali University Hospital, University of Iceland, Reykjavik, Iceland
| | - Christian M Rochefort
- School of Nursing, Faculty of Medicine and Health Sciences - Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre de recherche du Centre Hospitalier Universitaire de Sherbrooke (CR-CHUS), University of Sherbrooke, Longueuil, Canada
| | - Luk Bruyneel
- Department for Public Health and Primary Care, KU Leuven - University of Leuven, Leuven Institute for Healthcare Policy, Leuven, Belgium
| | - Renate Stemmer
- Faculty of Health and Nursing, Catholic University of Applied Sciences Mainz, Mainz, Germany
| | | | - Marcel Leppée
- Project Department, Institute for Healthy Ageing, Zagreb, Croatia
| | - Alvisa Palese
- Department of Medical Science, University Udine, Udine, Italy
| | | |
Collapse
|
36
|
Goh PQL, Ser TF, Cooper S, Cheng LJ, Liaw SY. Nursing teamwork in general ward settings: A mixed‐methods exploratory study among enrolled and registered nurses. J Clin Nurs 2020; 29:3802-3811. [DOI: 10.1111/jocn.15410] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/03/2020] [Accepted: 06/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Pearlyn Qin Ling Goh
- Department of Nursing Khoo Teck Puat HospitalYishun Health CampusNational Healthcare Group Singapore City Singapore
| | - Ting Fang Ser
- Department of Nursing Khoo Teck Puat HospitalYishun Health CampusNational Healthcare Group Singapore City Singapore
| | - Simon Cooper
- School of Health Federation University Churchill VIC Australia
| | - Ling Jie Cheng
- Department of Nursing Khoo Teck Puat HospitalYishun Health CampusNational Healthcare Group Singapore City Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies Yong Loo Lin School of MedicineNational University of Singapore Singapore City Singapore
| |
Collapse
|
37
|
Turkish Validation of the MISSCARE Survey - Pediatric Version. J Pediatr Nurs 2020; 53:e156-e163. [PMID: 32253092 DOI: 10.1016/j.pedn.2020.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE To conduct Turkish validity and reliability study of the MISSCARE Survey-Pediatric version identifying the missed nursing care in pediatric units and its reasons. DESIGN AND METHODS The sample of this methodological study consisted of 222 nurses working in pediatric units. The study was conducted in three training and research hospitals and one university hospital. In the Turkish adaptation of the survey, confirmatory and explanatory factor analyses were performed within the context of language validity, content validity, and construct validity. In the reliability analyses of the survey, Cronbach's alpha for internal consistency analysis and intraclass correlation analysis for test re-test were used. RESULTS The language validity of the survey was conducted by expert linguists. Content validity index was calculated as 0.88 for section A and 0.90 for section B. Turkish version consisting of three factors and 16 items for section B of the survey met the construct validity. In reliability analyses it was determined that Cronbach's alpha values were between 0.82 and 0.88 in subscales of the survey and Intraclass Correlation Coefficient values were between 0.52 and 0.65 in subscales of the survey and 0.64 in overall survey. CONCLUSION In the Turkish version of MISSCARE Survey-Pediatric version, the section A with 29 items and the section B with 16 items were valid and reliable. PRACTICE IMPLICATIONS The survey is a valid and reliable tool for intercultural studies revealing the nursing care activities missed by nurses working in pediatric clinics and the reasons for such activities.
Collapse
|
38
|
Cordeiro R, Pires Rodrigues MJ, Serra RD, Calha A. Good practices to reduce unfinished nursing care: An integrative review. J Nurs Manag 2020; 28:1798-1804. [DOI: 10.1111/jonm.12972] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/26/2020] [Accepted: 02/02/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Raul Cordeiro
- Polytechnic Institute of Portalegre (IPP) Portalegre Portugal
- VALORIZA ‐ Research Centre for Endogenous Resource Valorization Portalegre Portugal
| | | | - Ricardo Daniel Serra
- Unidade Local de Saúde do Norte Alentejano Polytechnic Institute of Portalegre (IPP) Portalegre Portugal
| | - António Calha
- Polytechnic Institute of Portalegre (IPP) Portalegre Portugal
- VALORIZA ‐ Research Centre for Endogenous Resource Valorization Portalegre Portugal
| |
Collapse
|
39
|
Zhao Y, Ma D, Wan Z, Sun D, Li H, Sun J. Associations between work environment and implicit rationing of nursing care: A systematic review. J Nurs Manag 2019; 28:1841-1850. [DOI: 10.1111/jonm.12895] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/20/2019] [Accepted: 10/31/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Yingnan Zhao
- School of Nursing Jilin University Changchun China
| | - Dongfei Ma
- School of Nursing Jilin University Changchun China
| | - Zhenzhen Wan
- School of Nursing Jilin University Changchun China
| | - Dan Sun
- School of Nursing Jilin University Changchun China
| | - Huanhuan Li
- School of Nursing Jilin University Changchun China
| | - Jiao Sun
- School of Nursing Jilin University Changchun China
| |
Collapse
|
40
|
Cucolo DF, Perroca MG. The qualitative dimension of Nursing workload: a measurement proposal. Rev Lat Am Enfermagem 2019; 27:e3238. [PMID: 31826169 PMCID: PMC6896804 DOI: 10.1590/1518-8345.3274.3238] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 09/23/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE construct and test a proposal to measure the qualitative dimension of nursing workload; identify the workload cut-off point and its indicator as predictors of the good and optimal nursing care product score. METHOD this is a descriptive study conducted in four inpatient units and four intensive care units of a Brazilian teaching hospital, considering 308 evaluations performed by 19 nurses. Four measurement instruments were used: three to assess the care demand in relation to nursing and the other to classify the care product delivered at the end of the shift. The workload was calculated and its indicator was constructed. RESULTS a weak and inverse correlation was found between the care product score, workload and the workload indicator and the workload indicator in the units and moderate and inverse between Nursing care planning and Care needs assistance with the number of hospitalized patients. CONCLUSION it is possible to associate workload and its indicator with the care product. Nursing workload ≤ 173 hours (24 hours) and indicator ≤ 12.3 hours / professional were associated with a higher probability of obtaining a "good" and "optimal" score in the care product in the inpatient units.
Collapse
Affiliation(s)
| | - Marcia Galan Perroca
- Faculdade de Medicina de São José do Rio Preto, Departamento de Enfermagem Especializada, São José do Rio Preto, SP, Brazil
| |
Collapse
|
41
|
Wei H, Corbett RW, Rose MA, Wei TL. Parents' and healthcare professionals' perceptions of the quality of care: A PITSTOP model of caring. Nurs Forum 2019; 54:661-668. [PMID: 31583716 DOI: 10.1111/nuf.12391] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Quality of care is measured by various indicators. Besides objective quantifications, it is necessary to understand the meaning of quality of care from the perspectives of patients, families, and healthcare professionals. OBJECTIVES This study aimed to understand parents' and healthcare professionals' perceptions of the quality of care. METHODS This was a secondary data analysis of two qualitative studies examining parents' and healthcare professionals' perceptions of caring in 2014 and 2018, respectively. Both studies took place in a children's hospital in the United States. There were 40 participants, 13 parents of children undergoing heart surgery and 27 healthcare professionals. The current study focused on parents' and healthcare professionals' viewpoints about the quality of care. RESULTS Seven themes emerged: patient-centered care, interprofessional collaboration, team communication, safety and security, trusting relationships, optimal outcomes, and positive patient experiences. The acronym PITSTOP was developed to enable healthcare professionals to recall the elements deemed as important to the quality of care by parents and professionals. CONCLUSIONS This study brought up a novice opinion that healthcare should be like a "pitstop," not just a "repair shop." Healthcare encounters may be brief but invaluable in helping patients and families succeed in their health promotion.
Collapse
Affiliation(s)
- Holly Wei
- Department of Advanced Nursing Practice and Education, College of Nursing, East Carolina University, Greenville, North Carolina
| | - Robin Webb Corbett
- Department of Advanced Nursing Practice and Education, College of Nursing, East Carolina University, Greenville, North Carolina
| | - Mary Ann Rose
- Department of Advanced Nursing Practice and Education, College of Nursing, East Carolina University, Greenville, North Carolina
| | - Trent L Wei
- Department of Internal Medicine, Duke University Hospital, Durham, North Carolina
| |
Collapse
|
42
|
Albsoul R, FitzGerald G, Finucane J, Borkoles E. Factors influencing missed nursing care in public hospitals in Australia: An exploratory mixed methods study. Int J Health Plann Manage 2019; 34:e1820-e1832. [PMID: 31448478 DOI: 10.1002/hpm.2898] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/14/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Missed nursing care (MNC) is a significant health care issue that impacts on the quality of health care and patient safety. It refers to delayed or omitted aspects of nursing care (totally or partially). MNC is an under-researched area in the Australian health care context. OBJECTIVE This research sought to further explore the MNC phenomenon in the context of an acute care hospital and to identify its common elements and the factors influencing its occurrence. DESIGN A convergent parallel mixed methods design was employed involving secondary analysis of routinely collected hospital data and a survey of 44 nursing staff using the MISSCARE survey instrument. The two sources of data were converged to address the objective. FINDINGS The study found that the most common elements of missed nursing care include failure of patient ambulation, emotional support for patients and/or family, and the provision of full documentation. These elements are consistent with previous international studies conducted in acute care hospital settings. This study identified that local context impacting on MNC was also important and included interruptions to workflow, "perceived" lack of management support, poor handover, and communication breakdown between the nursing team and medical staff. CONCLUSION Consideration of the local health care context is foundational in understanding the MNC phenomenon. The findings of this research may help nursing managers mitigate the possible effects of MNC and therefore improve patient safety in their acute care environment. Additional multisite studies are required to further explore factors associated with MNC in both general and local contexts.
Collapse
Affiliation(s)
- Rania Albsoul
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Gerard FitzGerald
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Julie Finucane
- School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Erika Borkoles
- School of Medicine, Griffith University, Gold Coast, QLD, Australia
| |
Collapse
|
43
|
Mandal L, Seethalakshmi A, Rajendrababu A. Rationing of nursing care, a deviation from holistic nursing: A systematic review. Nurs Philos 2019; 21:e12257. [DOI: 10.1111/nup.12257] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 01/23/2023]
Affiliation(s)
- Lata Mandal
- Faculty of Nursing Sri Ramachandra Institute of Higher Education and Research Chennai India
| | | | | |
Collapse
|
44
|
Kearns AJ. “Ought implies can” & missed care. Nurs Philos 2019; 21:e12272. [DOI: 10.1111/nup.12272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Alan J. Kearns
- Faculty of Humanities & Social Sciences, School of Theology, Philosophy, and Music Dublin City University Dublin Ireland
| |
Collapse
|
45
|
Bragadóttir H, Kalisch BJ, Bergthóra Tryggvadóttir G. The extent to which adequacy of staffing predicts nursing teamwork in hospitals. J Clin Nurs 2019; 28:4298-4309. [PMID: 31241808 DOI: 10.1111/jocn.14975] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 05/31/2019] [Accepted: 06/16/2019] [Indexed: 12/30/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study was to examine the extent to which staffing adequacy predicts nursing teamwork, controlling for demographic and background variables. BACKGROUND Findings from former studies indicate that hospital, unit and staff characteristics may be related to nursing teamwork, such as type of hospital and unit, role, gender, age, work experience, type of shift worked, shift length, number of working hours per week, overtime and staffing adequacy. Teamwork as well as staffing is identified as significant contributors to patient and staff safety in hospitals. However, the contribution of staffing to the quality of nursing teamwork is scarcely studied. DESIGN This was a quantitative descriptive cross-sectional study using the paper-and-pencil questionnaire Nursing Teamwork Survey-Icelandic. METHODS The study was conducted in 27 inpatient units in eight hospitals in Iceland with a sample of 925 nursing staff members. Participants were 567 registered nurses, practical nurses, unit secretaries and nurse unit managers. The Strengthening the Reporting of Observational Studies in Epidemiology checklist was used for this paper. RESULTS When controlling for unit type, role, experience on current unit and intent to leave, perceived adequacy of staffing alone explains up to 10% of overall teamwork. Unit type, role, years of experience on current unit and perceived staffing adequacy correlated significantly with overall teamwork. CONCLUSIONS The findings of this study indicate that unit and staff characteristics, including perceived adequacy of staffing, are associated with and explain the variability in nursing teamwork on inpatient hospital units. The findings of this study provide important information for clinical nurses, nurse managers, policymakers and instructors in health care. RELEVANCE TO CLINICAL PRACTICE The findings underline the importance of adequate staffing for nursing teamwork in inpatient hospital units.
Collapse
Affiliation(s)
- Helga Bragadóttir
- Faculty of Nursing, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Landspitali University Hospital, Reykjavik, Iceland
| | | | | |
Collapse
|
46
|
Qureshi SM, Purdy N, Mohani A, Neumann WP. Predicting the effect of nurse–patient ratio on nurse workload and care quality using discrete event simulation. J Nurs Manag 2019; 27:971-980. [DOI: 10.1111/jonm.12757] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 01/14/2019] [Accepted: 02/05/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Sadeem Munawar Qureshi
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering Ryerson University Toronto Ontario Canada
| | - Nancy Purdy
- Daphne Cockwell School of Nursing Ryerson University Toronto Ontario Canada
| | - Asad Mohani
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering Ryerson University Toronto Ontario Canada
| | - W. Patrick Neumann
- Human Factors Engineering Lab, Department of Mechanical and Industrial Engineering Ryerson University Toronto Ontario Canada
| |
Collapse
|
47
|
Huang J, Yang L, Zhuang Y, Qi H, Chen X, Lv K. Current status and influencing factors of barriers to enteral feeding of critically ill patients: A multicenter study. J Clin Nurs 2018; 28:677-685. [PMID: 30182514 DOI: 10.1111/jocn.14667] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 08/06/2018] [Accepted: 08/11/2018] [Indexed: 01/07/2023]
Abstract
AIMS AND OBJECTIVES To investigate the barriers in administering enteral feeding to critically ill patients from the nursing perspective. Our objectives are to provide tailored interventions for addressing identified barriers and propose an optimal enteral nutrition (EN) practice in intensive care unit (ICU). BACKGROUND Despite the availability of numerous verified clinical practice guidelines focusing on enteral feeding of critically ill patients, a wide gap remains between the guideline recommendations and actual nutrition performances. Underfeeding is also a global problem. Therefore, to further understand the reasons of the systemic iatrogenic underfeeding in ICUs, several potential issues are investigated. DESIGN This research is a cross-sectional descriptive study. METHODS A total of 808 nurses were recruited from 10 comprehensive hospitals from different districts in China. The nursing staff demographic, the unit's EN management information and the Chinese version of barriers to enteral feeding critically ill patients questionnaire were the parameters used to collect data via WeChat app. Moreover, the collected data were analysed by descriptive and correlative statistical analysis methods. RESULTS Results obtained by multiple linear regression showed that frequency of EN-related training, full-time ICU nutritionist, hospital level, specific protocols for enteral feeding and position were significantly influencing the enteral feeding of ICU patients. CONCLUSIONS Enteral feeding barriers of ICU patients are at a moderate level and are influenced by multiple aspects. Hence, hospital departments should strengthen standardisation and systematic EN training, provide ICU full-time nutritionists and distribute medical resources and personnel rationally. Moreover, construction of a localised feeding process and exerting subjective initiative of clinical nurses from an evidence-based guideline are important. Multifaceted tailored interventions should be implemented to address these barriers. RELEVANCE TO CLINICAL PRACTICE The findings of this study can be used to inform future intervention and guidelines aimed at addressing these barriers systematically and improving adherence to critical care nutrition guidelines for the provision of enteral nutrition.
Collapse
Affiliation(s)
- Jingying Huang
- Intensive Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lili Yang
- Nursing Education Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yiyu Zhuang
- Nursing Department, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Haiou Qi
- Operating Room, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xiangpin Chen
- Intensive Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Kai Lv
- Postanesthesia Care Unit, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| |
Collapse
|
48
|
Bragadóttir H, Kalisch BJ. Comparison of reports of missed nursing care: Registered Nurses vs. practical nurses in hospitals. Scand J Caring Sci 2018; 32:1227-1236. [PMID: 29603312 DOI: 10.1111/scs.12570] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/13/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND Missed nursing care is an error of omission defined as standard, required nursing care that is not completed or is seriously delayed. Study findings from around the world show that missed nursing care is a global concern. PURPOSE The purpose of this study was to compare reports of missed nursing care by two types of nurses - registered nurses and practical nurses - in acute care hospitals in Iceland. Former studies in the USA indicate a variance in reports of missed nursing care by staff with different roles. METHODS This was a cross-sectional descriptive study using the MISSCARE Survey-Icelandic questionnaire for data collection. The questionnaire asks about the amount of missed nursing care on the unit for 24 nursing elements (Part A) and 17 reasons of care being missed (Part B). Participants were nursing staff from medical, surgical and intensive care units in all hospitals in Iceland. FINDINGS A t-test for independent groups showed a significant difference for the overall missed nursing care score (Part A) between registered nurses (M = 2.09, SD = 0.51) and practical nurses (M = 1.82, SD = 0.59) [t(541) = 5.703, p < 0.001]. A comparison of the overall mean score for reasons of missed nursing care (Part B) between registered nurses (M = 2.32, SD = 0.38) and practical nurses (M = 2.21, SD = 0.62) indicated a significant difference in their reporting [t(299) = 2.210, p = 0.028]. In spite of the overall significant difference in ratings of the elements and reasons for missed nursing care by registered nurses and practical nurses, a pattern is evident in the ranking of the elements of nursing care being missed and reasons. CONCLUSIONS The findings of this study point to the need to acknowledge certain aspects of missed nursing care and the different roles within nursing. They indicate a need to improve open, sincere and structured communication and mutual respect and trust within healthcare teams in Icelandic hospitals.
Collapse
Affiliation(s)
- Helga Bragadóttir
- Faculty of Nursing, University of Iceland and Landspitali University Hospital, Reykjavik, Iceland
| | | |
Collapse
|
49
|
Braga LM, Parreira PMDSD, Arreguy-Sena C, Carlos DM, Mónico LDSM, Henriques MAP. TAXA DE INCIDÊNCIA E O USO DO FLUSHING NA PREVENÇÃO DAS OBSTRUÇÕES DE CATETER VENOSO PERIFÉRICO. TEXTO & CONTEXTO ENFERMAGEM 2018. [DOI: 10.1590/0104-07072018002810017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: avaliar a incidência cumulativa de obstrução do cateter venoso periférico e identificar o uso do flushing para prevenção das obstruções. Método: método misto, com estudo de coorte descritivo com seguimento de 110 pacientes de uma clínica médica de Portugal. A coleta de dados envolveu entrevistas com 22 enfermeiros, análise documental e observação participante. Realizada análise temática dos achados qualitativos e análise descritiva para os dados quantitativos. Resultados: a incidência cumulativa de obstrução foi 50%. As categorias temáticas desvelaram que o flushing era um cuidado para prevenção da obstrução do cateter venoso e realizado antes e/ou após a administração dos medicamentos. O volume de solução fisiológica utilizado no flushing variou entre 3 e 10 ml. Verificaram-se, também, situações de não adesão ao flushing e fatores que influenciavam nesta adesão, a saber: o tempo para realizar os cuidados, a complexidade e o grau de dependência dos pacientes, o volume de trabalho e o número de enfermeiros para prestar os cuidados. Conclusão: o flushing é um cuidado de enfermagem para a prevenção da obstrução do cateter venoso periférico, no entanto, as práticas de enfermagem para implementação não são uniformes quanto a frequência e volume de solução fisiológica. A ausência de um protocolo de enfermagem, a complexidade e o grau de dependência dos pacientes, o volume de trabalho e o número de enfermeiros são fatores capazes de influenciar na adesão à prática do flushing e consequentemente na incidência de obstrução do cateter venoso periférico e na segurança do paciente e qualidade dos cuidados.
Collapse
|