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Antoszewska A, Gutysz-Wojnicka A. Rationing of nursing care and assessment of work safety and a healthy work environment in intensive care units: A cross-sectional, correlational study. Intensive Crit Care Nurs 2024; 83:103667. [PMID: 38471399 DOI: 10.1016/j.iccn.2024.103667] [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: 09/18/2023] [Revised: 02/23/2024] [Accepted: 03/01/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Rationing of nursing care, whichrefers to the aspects of care not delivered by nurses in an intensive care unit (ICU), has implicationsfor patient outcomes and experiences. OBJECTIVES This study aimed to identify the extent to which nursing care is rationed in intensive care units, as well as asses quality of nursing care, and the level of job satisfaction and its correlation with an assessment of the climate of work safety, teamwork, and a healthy work environment. METHODOLOGY A cross-sectional, correlational study was conducted. The study included 226 ICU nurses. It was conducted with the use of three instruments: the Perceived Implicit Rationing of Nursing Care (PRINCA) questionnaire on the rationing of nursing care, assessment of patient care quality and job satisfaction, American Association of Critical-Care Nurses Healthy Work Environment Assessment Tool (HWEAT) and the Safe Attitudes and Behaviours Questionnaire questionnaire in the version: Teamwork and Safety Climate (BePoZa). SETTINGS Intensive Care Units in Warmia and Mazury Region in Poland. MAIN OUTCOME MEASURES Level of Nursing Care Rationing in Intensive Care Units. RESULTS The majority of participants were women (89.82 %) with a mean age of 42.47 years. The average score for nursing care rationing across all groups was 0.58. The mean score for the HWEAT was 2.7 and BePoZa was 3.72. The scores from the questionnaires were negatively correlated with the nursing care rationing scores, being -0.36 for the HWEAT and -0.45 for BePoZa. All correlation coefficients were statistically significant at a p-value of less than 0.05. CONCLUSIONS It is important to monitor work safety, teamwork climate, and standards of a healthy work environment in ICUs to minimise the risk of rationing nursing care. IMPLICATIONS FOR CLINICAL PRACTICE Interventions that enhance work organisation and teamwork can elevate nursing quality and job satisfaction in ICUs, while underestimating patient care tasks; thus, highlighting the need for further research on the factors influencing nursing performance.
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Affiliation(s)
- Anna Antoszewska
- School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Department of Nursing, Żołnierska 14c Street, 10-561 Olsztyn, Poland.
| | - Aleksandra Gutysz-Wojnicka
- School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Department of Nursing, Żołnierska 14c Street, 10-561 Olsztyn, Poland.
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Kohanová D, Zrubcová D, Bartoníčková D, Solgajová A. Unmet care needs in psychiatric healthcare context: A systematized literature review. J Psychiatr Ment Health Nurs 2024. [PMID: 39016194 DOI: 10.1111/jpm.13083] [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: 01/24/2024] [Revised: 06/11/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care. This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE The findings of this review contribute valuable information to inform evidence-based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings. In addition, the review illuminates the far-reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. WHAT ARE THE IMPLICATIONS FOR PRACTICE Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them. In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery. Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity-focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. ABSTRACT INTRODUCTION: Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting. AIM To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings. METHODS The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta-analyses. RESULTS This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient. DISCUSSION The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings. IMPLICATION FOR PRACTICE Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting.
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Affiliation(s)
- Dominika Kohanová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
| | - Dana Zrubcová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
| | - Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Andrea Solgajová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
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Milani A, Saiani L, Misurelli E, Lacapra S, Pravettoni G, Magon G, Mazzocco K. The relevance of the contribution of psychoneuroendocrinoimmunology and psychology of reasoning and decision making to nursing science: A discursive paper. J Adv Nurs 2024; 80:2943-2957. [PMID: 38318634 DOI: 10.1111/jan.16087] [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: 03/05/2023] [Revised: 11/20/2023] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
AIM Patients' death or adverse events appear to be associated with poor healthcare decision-making. This might be due to an inability to have an adequate representation of the problem or of the connections among problem-related elements. Changing how a problem is formulated can reduce biases in clinical reasoning. The purpose of this article is to explore the possible contributions of psychoneuroendocrinoimmunology (PNEI) and psychology of reasoning and decision-making (PRDM) to support a new nursing theoretical frame. DESIGN Discursive paper. METHOD This article discusses the main assumptions about nursing and nurses' ability to face patient's problems, suggesting a new approach that integrates knowledge from PNEI and PRDM. While PNEI explains the complexity of systems, highlighting the importance of systems connections in affecting health, PRDM underlines the importance of the informative context in creating a mental representation of the problem. Furthermore, PRDM suggests the need to pay attention to information that is not immediately explicit and its connections. CONCLUSION Nursing recognizes the patient-nurse relationship as the axiom that governs care. The integration of PNEI and PRDM in nursing theoretics allows the expansion of the axiom by providing essential elements to read a new type of relationship: the relationship among information. PNEI explains the relationships between biological systems and the psyche and between the whole individual and the environment; PRDM provides tools for the nurse's analytical thinking system to correctly process information and its connections. IMPACT ON NURSING PRACTICE A theoretical renewal is mandatory to improve nursing reasoning and nursing priority identification. Integrating PNEI and PRDM into nursing theoretics will modify the way professionals approach patients, reducing cognitive biases and medical errors. NO PATIENT OR PUBLIC CONTRIBUTION There was no patient or public involvement in the design or writing of this discursive article.
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Affiliation(s)
- Alessandra Milani
- Nursing Education, IEO, European Institute of Oncology IRCCS, Milan, Italy
- PhD Student, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | | | - Eliana Misurelli
- Nursing Education, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Silvana Lacapra
- Nursing Education, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Giorgio Magon
- Nursing Manager, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Ketti Mazzocco
- Department of Oncology and Haemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Cohen M, Drach-Zahavy A, Srulovici E. The dual protective role of accountability: Mitigating missed nursing care and nurse moral distress in a nested diary study design. J Clin Nurs 2024. [PMID: 38923756 DOI: 10.1111/jocn.17322] [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: 03/05/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
AIMS To examine a novel moderated-mediation model, investigating whether personal accountability moderates the link between nurse workload and missed nursing care and whether missed nursing care mediates the association between workload and moral distress. DESIGN Nested diary study. METHODS Data spanning from February 2019 to February 2023 were collected from 137 nurses working in various inpatient wards in two medium-sized hospitals. Nurses reported care given to specific patients on three to five occasions across different shifts, establishing nurse-patient dyads. Validated measures of missed nursing care, personal accountability, moral distress and workload were analyzed using mixed linear models to test the nested moderated-mediation model. RESULTS Under high workload conditions, nurses with higher personal accountability reported lower frequencies of missed nursing care compared to those with lower personal accountability. In contrast, under low workload conditions, personal accountability did not significantly influence missed nursing care occurrences. Furthermore, the interaction between workload and personal accountability indirectly affected nurses' moral distress through missed nursing care. Specifically, higher personal accountability combined with lower missed nursing care contributed to reduced levels of moral distress among nurses. CONCLUSION The study highlights accountability's dual role-safeguarding against care omissions and influencing nurses' moral distress amid rising workload pressures. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE Cultivating a culture of accountability within healthcare settings can serve as a protective factor against the negative effects of workload on patient care quality and nurse psychological distress, highlighting the need for organizational interventions to promote accountability among nursing staff. IMPACT By recognizing accountability's pivotal role, organizations can implement targeted interventions fostering accountability among nurses, including training programs focused on enhancing responsibility/ownership in care delivery and creating supportive environments prioritizing accountability to achieve positive patient outcomes. REPORTING METHOD The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Mirit Cohen
- Department of Nursing, The University of Haifa, Haifa, Israel
- Baruch Padeh Medical Center, Poriya, Israel
| | | | - Einav Srulovici
- Department of Nursing, The University of Haifa, Haifa, Israel
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Labrague LJ. Reality shock in newly graduated critical care nurses and its association with missed nursing care: The mediating role of caring ability. Intensive Crit Care Nurs 2024; 80:103554. [PMID: 37837835 DOI: 10.1016/j.iccn.2023.103554] [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: 05/26/2023] [Revised: 09/13/2023] [Accepted: 09/17/2023] [Indexed: 10/16/2023]
Abstract
OBJECTIVES This study is a report assessing the intermediary role of caring ability in the association between reality shock in newly graduated nurses and missed nursing care. RESEARCH METHODOLOGY/DESIGN This descriptive study involved 286 newly graduated nurses working in various critical care units. Three standardized scales were used to collect data, including the Missed Nursing Care Scale, the Environmental Reality Shock-Related Issues and Concerns (ERS-RIC) Scale, and the Caring Ability Inventory (CAI). The Hayes' PROCESS macro in SPSS (Model 4) was utilized to perform mediation testing. The data was collected from March 2022 to July 2022. SETTING Critical care units in seven Philippine hospitals. RESULTS Newly graduated critical care nurses reported moderate levels of reality shock (mean = 50.31). Reality shock was directly associated with missed nursing care (β = 0.0493, p = 0.0066). Caring ability partially mediated the association between reality shock and missed nursing care through caring ability (β = 0.0042, SE = 0.0027). CONCLUSIONS Newly graduated critical care nurses experience reality shock during the initial two years of employment. Reality shock diminishes the caring abilities of the newly graduated nurses, leading to a higher incidence of missed nursing care. IMPLICATIONS FOR CLINICAL PRACTICE Institutional strategies aimed at facilitating a smooth transition for newly graduated nurses should be prioritized to prevent a decline in their caring abilities and ultimately reduce compromises in nursing care.
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Labrague LJ, T Kostovich C. A Global Overview of Missed Nursing Care During the COVID-19 Pandemic: A Systematic Review. West J Nurs Res 2024; 46:133-142. [PMID: 38014816 DOI: 10.1177/01939459231214598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has placed unparalleled pressure on many countries' healthcare systems, impacting the delivery of health and nursing care services. Despite the growing number of missed care studies during the pandemic, a broader perspective is essential when designing theory-driven strategies to improve nursing care delivery. This review aimed to synthesize evidence of missed nursing care during the COVID-19 pandemic in acute care settings through a systematic review and narrative synthesis. An electronic search of articles published since the emergence of the pandemic was conducted using 5 databases (Scopus, PubMed, Web of Science, CINAHL, and PsycINFO). A total of 470 articles were identified during the initial search, and 10 articles were included in the review. The sample sizes of the studies ranged from 37 to 536 nurses. Results of the content analysis were grouped into 5 categories: (1) prevalence of missed care, (2) frequency of missed care, (3) reasons for missed care, (4) nurses' and organizational variables contributing to missed care, and (5) work environment elements contributing to missed care. The review's findings revealed a shift in the nature of missed nursing care during the pandemic, with an emphasis on nursing care tasks vital for the recovery of patients with COVID-19. Despite the unique circumstances brought about by the pandemic, an inadequate nursing workforce continued to be identified as the primary reason for missed care, consistent with the pre-pandemic period.
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Affiliation(s)
- Leodoro J Labrague
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Carol T Kostovich
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
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El-Gazar HE, Abousoliman AD, Shawer M, Coelho P, Zoromba MA. How nursing practice environments limit implicit rationing of care and nurse-assessed adverse events: the role of flow at work. BMC Nurs 2024; 23:19. [PMID: 38172826 PMCID: PMC10765756 DOI: 10.1186/s12912-023-01644-8] [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: 06/12/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The nursing practice environment is beneficial in curbing implicit rationing of nursing care and adverse patient events. However, the underlying mechanisms of these relationships remain unexplored. AIM To test whether flow at work mediates the relationship between the nursing practice environment, implicit rationing of nursing care, and nurse-assessed adverse patient events. METHODS This cross-sectional study involved 231 nurses from five hospitals in Port Said, Egypt. The participants completed Arabic-translated versions of the Practice Environment Scale of the Nursing Work Index, the Work-Related Flow Inventory, the Perceived Implicit Rationing of Nursing Care instrument, and the Adverse Patient Events scale. Structural equation modeling was used to test the hypothetical model. RESULTS The favorable nursing practice environment positively predicted nurses' flow at work (β = 0.64, p < 0.001), while inversely predicting implicit rationing of nursing care (β = -0.23, p = 0.014) and adverse patient events (β = -0.35, p < 0.001). Nurses' flow at work inversely predicted implicit rationing of nursing care (β = -0.30, p = 0.002) and adverse patient events (β = -0.29, p = 0.002). Moreover, nurses' flow at work acted as a mediator, linking the nursing practice environment to the rationing of nursing care and adverse patient events, with 500 bootstrap results for the indirect effects (β = -0.24, p = 0.001, 95% CI: -0.43 to -0.09; and β = -0.44, p = 0.003, 95% CI: -0.79 to -0.16, respectively). CONCLUSION Nurses working in a favorable nursing practice environment are more likely to experience flow at work, limiting implicit rationing of nursing care and adverse patient events. IMPLICATIONS FOR NURSING MANAGEMENT Nursing administrators should strive to create a healthy nursing practice environment to foster nurses' flow and thereby reduce the frequency of implicit rationing of nursing care and adverse patient events.
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Affiliation(s)
- Heba E El-Gazar
- Nursing Administration Department, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Ali D Abousoliman
- Nursing Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Nursing Administration Department, Faculty of Nursing, Kafrelsheikh University, Kafr el-sheikh, Egypt
| | - Mona Shawer
- High Institution of Nursing, Mansoura, Egypt
- Nursing Education and Training, King's College Hospital London, Jeddah, Saudi Arabia
| | - Paulo Coelho
- Nursing Department, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia
| | - Mohamed A Zoromba
- Nursing Department, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia.
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt.
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Hendy A, Abdel Fattah HA, Abouelela MA, Atia GAE, Alshammari MSS, Hables RMM, Alzahrani NS, Hendy A, Almarwani AM. Nursing Professional Commitment as a Mediator of the Relationship Between Work Environment and Missed Nursing Care Among Nurses: A Cross-Sectional Analysis. SAGE Open Nurs 2024; 10:23779608231226063. [PMID: 38250456 PMCID: PMC10798127 DOI: 10.1177/23779608231226063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 12/12/2023] [Accepted: 12/22/2023] [Indexed: 01/23/2024] Open
Abstract
Introduction Nursing care plays a pivotal role in promoting patient well-being and optimizing health outcomes. The nursing profession is characterized by its commitment to delivering high-quality care to patients. Objective The purpose of the study was to explore the role of nursing professional commitment as a mediator between the work environment and missed nursing care. Methods A cross-sectional analysis study "STROBE guideline" used an online structured questionnaire to collect data. It was conducted on a sample of 813 nurses who worked at seven governmental hospitals in Egypt, in the hospital wards, operating rooms, intensive care unit (ICU) or outpatient clinics, during a 4-month period from April to August 2022. Researchers used Characteristics of nurses, Nursing Work Index-Revised, Nursing Professional Commitment Scale, and MISSCARE Questionnaire to collect the data. Structural equation modeling by AMOS was used for testing nursing professional commitment as a mediator between the work environment and missed nursing care. Nurses' professional commitment was used as a mediator between work environment and missing nursing care. Results The working environment has a direct impact of -0.175, an indirect impact of -0.139, and a total impact of -0.314. Furthermore, professional commitment has a direct impact of -0.421. Additionally, when the working environment increases by 1, professional commitment increases by 0.33. Similarly, when the working environment increases by 1, missed care decreases by 0.175. Moreover, when professional commitment, as a mediating factor, increases by 1, missed care decreases by 0.421. Conclusion In conclusion, the findings of this study highlight the significant role of professional commitment as an intermediary factor between the working environment and missed nursing care. According to these results, it is necessary to formulate and implement intervention strategies to improve nurses' professional commitment and working environment, which is the key to reducing their missed nursing care.
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Affiliation(s)
- Abdelaziz Hendy
- Pediatric Nursing Department, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | | | | | - Gehan Abd elfattah Atia
- Medical-Surgical Nursing Department, Faculty of Nursing, Jouf University, Sakākā, Saudi Arabia
- Medical-Surgical Nursing Department, Faculty of Nursing, Menoufia University, Menoufia, Egypt
| | | | - Reda Mhmoud Mohamed Hables
- Department of Obstetrics and Gynecology Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
- College of Applied Medical Science, University of Hafar Albatin, Hafar Albatin, Saudi Arabia
| | - Naif S. Alzahrani
- Department of Medical – Surgical Nursing, College of Nursing, Taibah University, Medina, Saudi Arabia
| | - Ahmed Hendy
- Department of Computational Mathematics and Computer Science, Institute of Natural Sciences and Mathematics, Ural Federal University, Yekaterinburg, Russian Federation
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Simonetti M, Aiken LH, Lake ET. Association between the nurse work environment and patient experience in Chilean hospitals: A multi-hospital cross-sectional study. J Nurs Scholarsh 2023; 55:1248-1257. [PMID: 36991497 DOI: 10.1111/jnu.12898] [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: 07/08/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/31/2023]
Abstract
INTRODUCTION International evidence shows that nurses' work environments affect patient outcomes, including their care experiences. In Chile, several factors negatively affect the work environment, but they have not been addressed in prior research. The aim of this study was to measure the quality of the nurse work environment in Chilean hospitals and its association with patient experience. DESIGN A cross-sectional study of 40 adult general high-complexity hospitals across Chile. METHODS Participants included bedside nurses (n = 1632) and patients (n = 2017) in medical or surgical wards, who responded to a survey. The work environment was measured through the Practice Environment Scale of the Nursing Work Index. Hospitals were categorized as having a good or poor work environment. A set of patient experience outcomes were measured through the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Adjusted logistic regression models were used to test associations between the environment and patient experiences. RESULTS For all outcomes, the percentage of patients satisfied was higher in hospitals with good as compared to poor work environments. In good environment hospitals patients had significantly higher odds of being satisfied with communication with nurses (OR 1.46, 95% CI: 1.10-1.94, p = 0.010), with pain control (OR 1.52, 95% CI: 1.14-2.02, p = 0.004), and with nurses' timely responses in helping them to go to the bathroom (OR 2.17, 95% CI: 1.49-3.16, p < 0.0001). CONCLUSIONS Hospitals with good environments outperform hospitals with poor environments in most patient care experience indicators. Efforts to improve nurses' work environment hold promise for improving patient experiences in Chilean hospitals. CLINICAL RELEVANCE Hospital administrators and nurse managers should value, especially in the context of financial constraints and understaffing, the implementation of strategies to improve the quality of nurses´ work environments so that they can provide patients with a better care experience.
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Affiliation(s)
- Marta Simonetti
- Universidad de los Andes, Chile, Escuela de Enfermería, Santiago, Chile
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Jones-Hooker C, Tyndall DE, Forbes TH. The Disruption of Patient Ambulation Care Processes by COVID-19: Revealing the Value of Visitor Assistance. J Nurs Adm 2023; 53:520-525. [PMID: 37747175 DOI: 10.1097/nna.0000000000001328] [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: 09/26/2023]
Abstract
OBJECTIVE To explore the impact of COVID-19 on care processes and ambulation outcomes. BACKGROUND COVID-19 forced hospital leaders to make systems-level changes that disrupted patient ambulation. The impact of these changes on the ambulation of hospitalized patients was unknown. The Systems Engineering Initiative for Patient Safety model was used to explore ambulation from a systems perspective. METHODS A single-case study research design was used to investigate patient ambulation in a major medical center. Data from 12 interviews with interdisciplinary leaders were analyzed. RESULTS Staff shortages and visitor restrictions were identified as the main work system barriers to ambulation. These barriers disrupted usual ambulation processes and supported the value of visitor assistance with ambulation. CONCLUSIONS This study provides a systems-level perspective of missed ambulation during COVID-19, which revealed the value of ambulation assistance provided by visitors. Findings may be used to support the continued and increased involvement of family members and visitors in the process of ambulation.
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Affiliation(s)
- Christa Jones-Hooker
- Author Affiliations: Nursing Instructor (Dr Jones-Hooker), Wake Technical Community College, Raleigh; and Associate Professor (Dr. Tyndall), School of Nursing, UNC Wilmington, Wilmington, North Carolina; and Assistant Professor (Dr Forbes), College of Nursing, East Carolina University, Greenville, North Carolina
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Haegdorens F. Commentary: Cultural adaptation of the revised Basel Instrument for Rationing of Care to the Turkish context: a study of validity and reliability. J Res Nurs 2023; 28:352-353. [PMID: 37885956 PMCID: PMC10599307 DOI: 10.1177/17449871231178929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023] Open
Affiliation(s)
- Filip Haegdorens
- Principal Research Fellow, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium
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Albsoul RA, Alshyyab MA, Hughes JA, Jones L, FitzGerald G. A Cross-sectional Study Evaluating the Association Between the Nursing Practice Environment and Missed Nursing Care in Medical and Surgical Wards in Jordan. J Nurs Care Qual 2023; 38:E34-E41. [PMID: 36693623 DOI: 10.1097/ncq.0000000000000692] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Missed nursing care can jeopardize the safety of patients. The practice environment contains various elements that may impact nursing staff's capability to provide appropriate care. PURPOSE To examine the association between the practice environment and missed nursing care in Jordanian hospitals. METHODS A cross-sectional design, including the MISSCARE survey and the Practice Environment Scale of the Nursing Work Index, was used for this study. RESULTS Data were gathered from 672 nurses working in 10 hospitals between March and July 2021. Findings revealed significant negative correlations between nurses' participation in hospital affairs ( r = -0.077, P = .046), nursing foundations for quality of care ( r = -0.139, P < .001), and missed nursing care. CONCLUSION Information from this study can help nursing leaders modify practice environment elements that impact missed nursing care occurrences, which will help improve the quality of care provided to patients.
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Affiliation(s)
- Rania Ali Albsoul
- Department of Family and Community Medicine, School of Medicine, The University of Jordan, Amman, Jordan (Dr Albsoul); Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan (Dr Alshyyab); Schools of Nursing (Dr Hughes) and Public Health and Social Work (Mr Jones and Dr FitzGerald), Queensland University of Technology, Kelvin Grove, Brisbane, Queensland, Australia
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13
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Lake ET, Staiger D, Smith JG, Rogowski JA. The Association of Missed Nursing Care With Very Low Birthweight Infant Outcomes. Med Care Res Rev 2023; 80:293-302. [PMID: 36692294 PMCID: PMC10121798 DOI: 10.1177/10775587221150950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The health outcomes of very low birthweight (VLBW) infants in neonatal intensive care units (NICUs) may be jeopardized when required nursing care is missed. This correlational study is the first to look at the association between missed nursing care and mortality, morbidity, and length of stay (LOS) for VLBW infants in a U.S. NICU sample. We used 2016 hospital administrative discharge abstracts for VLBW newborns (n = 7,595) and NICU registered nurse survey responses (n = 6,963) from the National Database of Nursing Quality Indicators. The 190 sample hospitals were from 19 states in all regions. Missed clinical nursing care was significantly associated with higher odds of bloodstream infection and longer LOS, but not mortality or severe intraventricular hemorrhage. With further research, these results may motivate the development of interventions to reduce missed clinical nursing care in the NICU.
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Affiliation(s)
- Eileen T. Lake
- University of Pennsylvania School of Nursing, Philadelphia, USA
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14
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Li HQ, Xie P, Huang X, Luo SX. The experience of nurses to reduce implicit rationing of nursing care: a phenomenological study. BMC Nurs 2023; 22:174. [PMID: 37208756 DOI: 10.1186/s12912-023-01334-5] [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: 11/18/2022] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Implicit rationing of nursing care can adversely affect patient safety and the quality of care, and increase nurses' burnout and turnover tendency. Implicit rationing care occurs at the nurse-to-patient level (micro-level), and nurses are direct participants. Therefore, the strategies based on experience of nurses to reduce implicit rationing care have more reference value and promotion significance. The aim of the study is to explore the experience of nurses to reduce implicit rationing care, thereby to provide references for conducting randomized controlled trials to reduce implicit rationing care. METHODS This is a descriptive phenomenological study. Purpose sampling was conducted nationwide. There are 17 nurses were selected and semi-structured in-depth interviews were conducted. The interviews were recorded, transcribed verbatim and analyzed via thematic analysis. RESULTS Our study found that nurses' reported experience of coping with implicit rationing of nursing care contained three aspects: personal, resource, and managerial. Three themes were extracted from the results of the study: (1) improving personal literacy; (2) supplying and optimizing resources and (3) standardizing management mode. The improvement of nurses' own qualities are the prerequisites, the supply and optimization of resources is an effective strategy, and clear scope of work has attracted the attention of nurses. CONCLUSION The experience of dealing with implicit nursing rationing includes many aspects. Nursing managers should be grounded in nurses' perspectives when developing strategies to reduce implicit rationing of nursing care. Promoting the improvement of nurses' skills, improving staffing level and optimizing scheduling mode are promising measures to reduce hidden nursing rationing.
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Affiliation(s)
- Hui Qin Li
- Mental Health Center, West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province, 610041, P.R. China
| | - Peng Xie
- Surgical Anesthesia Center, West China School of Nursing, West China Hospital, Sichuan University, No. 28 Telecom South Street, Chengdu, Sichuan Province, 610041, P.R. China
| | - Xia Huang
- Mental Health Center, West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province, 610041, P.R. China.
| | - Shan Xia Luo
- Mental Health Center, West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province, 610041, P.R. China.
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15
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Albsoul RA, Safadi RR, Alshyyab MA, FitzGerald G, Hughes JA, Ahmad M. Missed Nursing Care in Medical and Surgical Wards in Jordan: A Cross-Sectional Study. Policy Polit Nurs Pract 2023; 24:140-150. [PMID: 36798019 DOI: 10.1177/15271544231155845] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Missed nursing care is a multifaceted patient safety issue receiving increased attention among healthcare scholars worldwide. There is limited research on missed nursing care in the Jordanian healthcare context. The current study sought to examine the perceptions of Jordanian nurses toward the amount and types of missed nursing care in medical and surgical wards. We also examined the differences in missed care items between public, private, and university hospitals in Jordan. This was a cross-sectional study using the MISSCARE Survey tool. Data collection spanned 4 months between March and July 2021. The final study sample consisted of 672 registered nurses employed in five public, three private, and two university hospitals in Jordan. Data were analyzed using descriptive statistics, Analysis of variance, and Pearson correlation coefficent test. Of the 672 registered nurses who participated, the majority were females (n = 421; 62.6%). Most participants held a bachelor's degree in nursing (n = 577; 85.9%). The three most common missed nursing activities in the participating hospitals were: ambulation, oral care, and emotional support. Nurses working in public hospitals reported the highest missed nursing care. The age and number of patients under care significantly correlated with missed nursing care. The findings could help nursing managers develop plans to reduce missed nursing care in their healthcare institutions.
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Affiliation(s)
- Rania Ali Albsoul
- Department of Family and Community Medicine, School of Medicine, 54658The University of Jordan, Irbid, Jordan
| | - Reema Rafiq Safadi
- Department of Maternal and Child Health Nursing, School of Nursing, 54658The University of Jordan, Amman, Jordan
| | - Muhammad Ahmed Alshyyab
- Department of Public Health and Community Medicine, Faculty of Medicine, 37251Jordan University of Science and Technology, Amman, Jordan
| | - Gerard FitzGerald
- School of Public Health and Social Work, 1969Queensland University of Technology, Brisbane, Australia
| | - James A Hughes
- School of Nursing, 1969Queensland University of Technology, Brisbane, Australia
| | - Muayyad Ahmad
- Department of Clinical Nursing, School of Nursing, 54658The University of Jordan, Amman, Jordan
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16
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Shi F, Li Y, Zhao Y. How do nurses manage their work under time pressure? Occurrence of implicit rationing of nursing care in the intensive care unit: A qualitative study. Intensive Crit Care Nurs 2023; 75:103367. [PMID: 36543721 DOI: 10.1016/j.iccn.2022.103367] [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: 04/28/2022] [Revised: 11/24/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The aim of this study was to explore the experience of intensive care unit nurses under time pressure and the occurrence of implicit rationing under time pressure. METHODS In-depth audio-recorded interviews were conducted with 18 intensive care unit nurses. Colaizzi seven-step analysis of phenomenological data was used. FINDINGS Three themes emerged from the analysis: the influence of internal and external environments, perceived differences in time pressure, and broad coping styles. CONCLUSIONS Under the influence of various factors, including continuous or intermittent time pressure, nurses employ strategies to deal with the pressure. Sometimes, these strategies allow them to complete all their necessary work. However, with the increase in time pressure, sometimes some work that must be done is changed into work that should be done in the consciousness of nurses. In such cases, nurses choose the strategy of implicit rationing to deal with time pressure.
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Affiliation(s)
- Fang Shi
- Department of Intensive Care Unit, the First Affiliated Hospital of Soochow University, No. 899 Pinghai Street, Suzhou, Jiangsu, People's Republic of China
| | - Yuntao Li
- Department of Intensive Care Unit, the First Affiliated Hospital of Soochow University, No. 899 Pinghai Street, Suzhou, Jiangsu, People's Republic of China
| | - Yingnan Zhao
- Department of Intensive Care Unit, the First Affiliated Hospital of Soochow University, No. 899 Pinghai Street, Suzhou, Jiangsu, People's Republic of China.
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17
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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.
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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.
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18
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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.
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19
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Andersson I, Bååth C, Nilsson J, Eklund AJ. Validation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care, a Swedish version. Nurs Open 2023. [PMID: 36855246 DOI: 10.1002/nop2.1692] [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: 07/28/2022] [Revised: 01/04/2023] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
AIM The aim of the study was to translate, adapt and validate the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care for use in the Swedish community health care context. DESIGN A cross-sectional study. Data were collected from October 2019 to January 2020, and the questionnaire was sent to Registered Nurses, Enrolled Nurses and assistant nurses. METHODS The study was performed in four phases: (1) translation, (2) adaptation of the Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care to the Swedish context, (3) content validity testing, and (4) evaluation of psychometric properties. The collected data resulted in 611 responses. Explorative factor analysis was performed to explore the interrelationship, and Cronbach's alpha was used to evaluate the internal consistency. RESULTS Explorative factor analysis presented six factors/subscales: (1) fundamental care, (2) timely needed-based care, (3) dignity and support, (4) ensuring respectful treatment, (5) social activities, and (6) documentation, planning and reporting. The Cronbach's alpha for the components showed values between 0.7 and 0.9. CONCLUSION The analyses indicate an instrument to be usable for Enrolled Nurses and nurse assistants in community health care. Additional tests, can contribute to refining the content of the items and further test reliability and validity of the instrument. NO PATIENT OR PUBLIC CONTRIBUTION As this is a study of translation and validation of the instrument Basel Extent of Rationing of Nursing Care for Nursing Homes and Home Care.
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Affiliation(s)
- Ingrid Andersson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Carina Bååth
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Health, Welfare, and Organisation, Østfold University College, Halden, Norway
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Anna Josse Eklund
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
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20
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Xie LL, Jiang W, Niyomsilp E, Jing J, Feng L, Wen Y, Wang L, Zheng R. Effect of role overload on missed nursing care in China: The role of work addiction and leader-member exchange. Nurs Open 2022; 10:3153-3163. [PMID: 36564925 PMCID: PMC10077371 DOI: 10.1002/nop2.1565] [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: 07/18/2022] [Revised: 11/12/2022] [Accepted: 12/10/2022] [Indexed: 12/25/2022] Open
Abstract
AIM The aim was to examine the effect of role overload, work addiction and leader-member exchange on missed nursing care. DESIGN A cross-sectional study. METHODS Chinese registered nurses from five Sichuan province public hospitals were studied from March 2022-May 2022. The measurements were derived from a questionnaire on role overload, work addiction, missed nursing care, leader-member exchange and a sociodemographic datasheet. Descriptive statistics and inferential statistics were conducted (N = 403). RESULTS Role overload was associated with missed nursing care, and work addiction played a mediation role. Leader-member exchange negatively predicted work addiction and played a moderating role between role overload and work addiction. The effect of role overload on work addiction was attenuated when the level of leader-member exchange was higher. Promoting leader-member exchange could mitigate how role overload undermines missed nursing care.
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Affiliation(s)
- Lin-Li Xie
- University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, China.,School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Wenchun Jiang
- Department of Nursing, University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, China
| | - Eksiri Niyomsilp
- School of Management, Shinawatra University, Pathumthani, Thailand
| | - Jie Jing
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.,Department of Nursing, University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, China.,School of Management, Shinawatra University, Pathumthani, Thailand
| | - Lu Feng
- University of Electronic Science and Technology of China, Sichuan Provincial People's Hospital, Chengdu, China.,School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yilin Wen
- Shehong Municipal Hospital of Traditional Chinese Medicine, Shehong, China
| | - Li Wang
- The Second People's Hospital of Panzhihua, Panzhihua, China
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21
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Zárate-Grajales RA, Benítez-Chavira LA, Hernández-Corral S, Serván-Mori E, Nigenda G, Amaya-Aguilar JA, Interial-Gúzman MG, Fabián-Victoriano R, López-Cruz EA, Ortíz-López G, Moreno-Monsiváis MG. Nursing practice environment and missed care at highly specialised hospitals in Mexico: A cross-sectional observational study. Int J Health Plann Manage 2022; 38:628-642. [PMID: 36540043 DOI: 10.1002/hpm.3606] [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: 08/14/2022] [Revised: 11/26/2022] [Accepted: 12/09/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The influence of the work environment on missed care and service quality has been well documented. However, available evidence concerning this relationship comes mostly from developed countries. Few studies have been conducted in low- or middle-income countries. We assessed the relationship between the work environment and missed nursing care in highly specialised hospitals in Mexico. METHODS We conducted an observational cross-sectional study with data collected from January 2019 to February 2020 in 11 highly specialised hospitals (n = 510 nurses). We estimated missed nursing care utilising the MISSCARE questionnaire and used the Practice Environment Scale-Nursing Work Index instrument to assess the work environment. After describing the main attributes of the study sample according to the type of work environment, we constructed five adjusted fractional regression models, the first concerning the overall index of missed care, and the others pertaining to its various dimensions. RESULTS The sample analysed was balanced as regards adjustment variables according to the type of work environment. The adjusted estimates confirmed an inverse relationship between the missed care index and enjoying an enhanced, or favourable, work environment. Overall, the difference was 9 percentage points (pp); however, by dimension of missed care, the major differences between enhanced and attenuated, or unfavourable, work environments were registered for basic care, followed by patient education and discharge planning (4pp) and individual needs (8pp). CONCLUSIONS The work environment determines the frequency of missed nursing care, both overall and by dimension. Nursing managers need to create short- and mid-term strategies favouring positive work environments in order to improve working conditions for nursing professionals.
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Affiliation(s)
- Rosa A Zárate-Grajales
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Luis A Benítez-Chavira
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Sandra Hernández-Corral
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico.,National Institute of Rehabilitation, Mexico City, Mexico
| | | | - Gustavo Nigenda
- National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico
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22
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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: 13] [Impact Index Per Article: 6.5] [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.
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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
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23
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Gröschke D, Hofmann E, Müller ND, Wolf J. Individual and organizational resilience-Insights from healthcare providers in Germany during the COVID-19 pandemic. Front Psychol 2022; 13:965380. [PMID: 36092080 PMCID: PMC9453859 DOI: 10.3389/fpsyg.2022.965380] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/08/2022] [Indexed: 11/26/2022] Open
Abstract
We explored the effects of resilience in the healthcare setting during the COVID-19 pandemic in Germany. Our study sheds light on the cross-level effects of resilience in hospitals and thus responds to calls to research this empirically. In a cross-sectional study design, the perceptions of resilience of employees in hospitals and of transformations at the individual, team, and organizational level were analyzed. An online survey was conducted in summer 2020 in Germany in which 1,710 healthcare workers completed a self-report questionnaire. Results indicate that resilience is both a highly interrelated construct on the individual and organizational level and also positively linked to perceptions of transformation as an indicator for demonstration of resilience. We also found a partial mediation effect of organizational resilience and team efficacy, respectively, on the relationship between individual resilience and perceived transformation on the individual and organizational level as well as a full mediation on the team level. The study highlights the interdependence of individual and organizational resilience (which is mediated by team efficacy) and its impact on perceived transformation in German hospitals during the COVID-19 pandemic. Whereas team efficacy is crucial for performance in regular work operations, during a pandemic the organizational level becomes more relevant. Theoretical and practical implications are discussed.
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Affiliation(s)
- Daniela Gröschke
- Intercultural Human Resource Development and Organizational Development, Department of Intercultural Business Communication, Institute for German as a Foreign and Second Language and Intercultural Studies, Friedrich Schiller University, Jena, Germany
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24
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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.
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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.
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25
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Prevalence, type, and reasons for missed nursing care in municipality health care in Sweden – A cross sectional study. BMC Nurs 2022; 21:95. [PMID: 35462537 PMCID: PMC9035238 DOI: 10.1186/s12912-022-00874-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 04/14/2022] [Indexed: 11/22/2022] Open
Abstract
Background With an ageing population, there is an increasing need for care, both as home care and in nursing homes. However, some needed care is not carried out for different reasons, which can affect patient safety. The aim of the study was to describe prevalence, type, and reasons for missed nursing care in home care and nursing homes, from nurses’ perspective. Methods A cross sectional design with quantitative and qualitative approach. A Swedish version of Basel Extent of Rationing of Nursing Care for nursing homes and 15 study specific questions were answered by 624 registered nurses, enrolled nurses, or nurse assistants. Both descriptive and analytical, independent-samples t-test, analyses were used. Qualitative content analysis was used for the open-ended question. Results The care activity most often missed in home care was: ‘set up or update care plans’ (41.8%), and in nursing homes: ‘scheduled group activity’ (22.8%). Reasons for missed nursing care were lack of preparedness for unexpected situations, obstacles in a deficient work environment, unsatisfactory planning in the organisation, and/or shortcomings related to the individual. Conclusion Not all care activities needed are performed, due to reasons such as lack of time or organisational issues. Missed nursing care can lead to adverse events and affect patient safety. It is important to be aware of missed nursing care and the reasons for it, which gives a possibility to initiate quality improvement work to ensure patient safety.
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Safdari A, Rassouli M, Jafarizadeh R, Khademi F, Barasteh S. Causes of Missed Nursing Care During COVID-19 Pandemic: A Qualitative Study in Iran. Front Public Health 2022; 10:758156. [PMID: 35493392 PMCID: PMC9043243 DOI: 10.3389/fpubh.2022.758156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 03/15/2022] [Indexed: 11/30/2022] Open
Abstract
Background The unpredictable and variable nature of COVID-19 and the lack of healthcare resources has led to inadequate care for patients. This study aimed to explain the causes of missed nursing care during the COVID-19 pandemic from the perspective of Iranian nurses. Method This qualitative study was conducted using semi-structured interviews with 14 nurses caring for patients with COVID-19 in three hospitals in Iran. Sampling was performed by the purposive method. Data were analyzed using the conventional content analysis method. The interviews were first recorded and transcribed, and then the data were analyzed using the Elo and Kyngas method. Data management was done with MAXQDA software version 10. To achieve trustworthiness, the criteria presented by Lincoln and Guba were used. Findings A total of 14 nurses participated in the study. The mean age of participants was 31.85 ± 4.95 years, and the mean number of years of work experience was 7.71 ± 4.44. Eleven participants were women. Among all participants, nine had a bachelor's degree and five had a master's degree. Four nurses had fixed shifts, while ten nurses had rotating shifts. The causes of missed nursing care were categorized into 4 groups. The category “unfulfilled care” comprised the reasons for forgetting care, neglecting care, arbitrary elimination of care, and compulsory elimination of care. The category of “care at improper time” consisted of interference of the care in patients' daily activities and interference with other healthcare providers' activities. The “incomplete cares” category comprised failure to complete the care period in hospital, interruption in care, and discontinuance of care after patient discharge. The last category, “incorrect care,” consisted of providing care regardless of the nursing process, providing care by unqualified professionals, and providing trial-and-error care. Conclusion This study illustrates an understanding of the causes of missed nursing care during the COVID-19 pandemic from the perspective of nurses. The increasing demand for care caused by the pandemic and problems in the work environment has led to the failure of nurses to provide complete, correct care and sometimes miss parts of care to patients. Therefore, nursing policymakers and managers should develop and implement appropriate care protocols and instructions to minimize missed nursing care.
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Affiliation(s)
- Ali Safdari
- Student Research Committee, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Raana Jafarizadeh
- Department of Medicine, Ardabil Branch, Islamic Azad University, Ardabil, Iran
| | - Fatemeh Khademi
- Department of Nursing, Faculty of Nursing, Arak University of Medical Sciences, Arak, Iran
| | - Salman Barasteh
- Health Management Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
- *Correspondence: Salman Barasteh
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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.
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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
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Nantsupawat A, Poghosyan L, Wichaikhum OA, Kunaviktikul W, Fang Y, Kueakomoldej S, Thienthong H, Turale S. Nurse staffing, missed care, quality of care and adverse events: A cross-sectional study. J Nurs Manag 2022; 30:447-454. [PMID: 34719833 PMCID: PMC9017335 DOI: 10.1111/jonm.13501] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 10/14/2021] [Accepted: 10/27/2021] [Indexed: 12/11/2022]
Abstract
AIM This study aimed to illustrate the relationship between nurse staffing and missed care, and how missed care affects quality of care and adverse events in Thai hospitals. BACKGROUND Quality and safety are major priorities for health care system. Nurse staffing and missed care are associated with low quality of care and adverse events. However, examination of this relationship is limited in Thailand. METHODS This cross-sectional study collected data from 1188 nurses in five university hospitals across Thailand. The participants completed questionnaires that assessed the patient-to-nurse ratio, adequacy of staffing, missed care, quality of care and adverse events. Logistic regression models were used to estimate associations. RESULTS Higher patient-to-nurse ratio, poor staffing and lack of resource adequacy were significantly associated with higher odds of reporting missed care. Higher nurse-reported missed care was significantly associated with higher odds of adverse events and poor quality of care. CONCLUSIONS Poor nurse staffing was associated with missed care, and missed care was associated with adverse events and lower quality of care in Thai university hospitals. IMPLICATIONS FOR NURSING MANAGEMENT Improving nurse staffing and assuring adequate resources are recommended to reduce missed care and adverse events and increase quality of care.
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Affiliation(s)
| | | | | | - Wipada Kunaviktikul
- Assistant to the President in Health Science Panyapiwat
Institute of Management, Nonthaburi, Thailand
| | - Yaxuan Fang
- Chiang Mai University, Faculty of Nursing, Chiang Mai,
Thailand,School of Nursing, Southern Medical University, Guangzhou,
China
| | | | - Hunsa Thienthong
- Nursing Director, Nursing Service Division, Maharaj Nakorn
Chiang Mai Hospital, Chiang Mai, Thailand
| | - Sue Turale
- Visiting Professor, Faculty of Nursing, Chiang Mai,
Thailand
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Labrague LJ. Linking nurse practice environment, safety climate and job dimensions to missed nursing care. Int Nurs Rev 2021; 69:350-358. [PMID: 34878172 DOI: 10.1111/inr.12736] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 11/07/2021] [Indexed: 01/24/2023]
Abstract
AIM This study examined the aspects of the nurse practice environment and patient safety climate and the various job dimensions that contribute to the occurrence of missed nursing care. BACKGROUND Missed nursing care is a crucial healthcare concern that poses significant threats to patient safety. The available literature on missed nursing care is confined to high-resource nations, where hospital policies, mechanisms and processes to support professional nursing practice are well established. METHODS This is a multi-centre, cross-sectional study, using self-report scales, which involves 624 clinical nurses in selected hospitals in the Philippines. RESULTS Patient safety climate (β = -0.148, p = 0.001), decision authority (β = -0.101, p = 0.018) and staffing/resource adequacy (β = -0.086, p = 0.014) significantly predicted missed nursing care. Nurse, unit and hospital variables were not related with missed nursing care. DISCUSSION Nurses who perceived greater decision authority, positive safety climate and adequate staffing/resources were less likely to miss or omit patient care activities. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY Institutional measures to foster decision authority in nurses, improve safety climate and address staffing/resource issues can be a viable solution to reduce the occurrence of missed nursing care.
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Affiliation(s)
- Leodoro J Labrague
- Graduate School, St. Paul University Philippines, Tuguegarao, Philippines
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Tomaszewska K, Majchrowicz B, Ratusznik D. Rationing of Nursing Care on Example of Selected Health Care Facility. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312824. [PMID: 34886550 PMCID: PMC8657565 DOI: 10.3390/ijerph182312824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/29/2021] [Accepted: 12/03/2021] [Indexed: 12/25/2022]
Abstract
Contemporary health determinants require nurses to develop new competencies and skills while performing complex tasks in all forms of health care. The problem of rationing of care is present all over the world and usually occurs when available resources are too low to provide adequate care to all patients. The most common reasons for loss of care are shortages of nurses, use of modern treatment methods, increased demand for care by a large number of patients, and greater knowledge of patients about their rights. A questionnaire survey was conducted among 295 nurses employed in hospital wards. The survey was conducted from September to December 2020 using the standardized BERNCA (The Basel Extent of Rationing of Nursing Care) questionnaire to measure the level of rationing of nursing care. The research was hampered by the sanitation regime associated with the SARS CoV-2 pandemic. Nursing care rationing is dependent on seniority and place of work. The mean total BERNCA score of the degree of rationing of nursing care was 2.58 ± 0.96 on a scale of 0 to 4 (where 0 means "no need for it" and 4 means "often". The median score was 2.69. The higher frequency of rationing nursing care was characteristic of those working on surgical wards. The mean score obtained by them was 2.72 ± 0.86, with the median equal to 2.88. In the case of nurses employed in non-surgical wards, the scores were 2.08 ± 1.07 and 2.28, respectively. Rationing of nursing care is dependent on seniority and work location, with a higher degree of rationing of care occurring in surgical units.
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Affiliation(s)
- Katarzyna Tomaszewska
- Department of Nursing, Institute of Health Protection, The Bronisław Markiewicz State Higher School of Technology and Economics, 37-500 Jarosław, Poland
- Correspondence: ; Tel.: +48-795-580-108
| | - Bożena Majchrowicz
- Department of Nursing, Institute of Social and Health Sciences, East European State Higher School, 37-700 Przemyśl, Poland;
| | - Dorota Ratusznik
- Department of Nursing, Higher School of Health Sciences, Colegium Masoviense, 96-300 Żyrardów, Poland;
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Bellizzi S, Padrini S. Report of the "satisfaction" survey amongst public health services nurses in Port Said. BMC Nurs 2021; 20:199. [PMID: 34649536 PMCID: PMC8518242 DOI: 10.1186/s12912-021-00707-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 09/22/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND There is a paucity of evidence regarding the job experience of nurses in Egypt. An unpublished previous pilot study conducted in the Port Said Technical Nursing Institute, which was based on 36 participants, showed that almost half of nurses were satisfied with their job; on the other hand, nurses indicated low salaries and high work-loads as main reasons for dissatisfaction. We explored job satisfaction of nurses working in public health services of the Port Said Governorate to inform future healthcare policy. METHODS A cross-sectional study including nurses from different public health services was conducted. Questionnaires were delivered in a sample of primary health care facilities as well as in the Port Said Governorate public hospital. Following a literature review, eight components were identified as contributors to job satisfaction; two closed questions for each of the eight components and two open questions were devised for a total of 18 questions. RESULTS The final study population consisted of 285 individuals. Almost 40.0% of the participants felt safe in their clinical environment while around 10.0% disagree on this. Almost 70.0% of participants complained about high work-load due to shortage of staff in the respective clinical area. Almost 85.0% of nurses reported that their salary did not cover living cost while only 13.0% indicated earning a fair salary. Almost 60.0% agreed with the fact that they have regular opportunities to develop in their career. CONCLUSION Increasing job satisfaction among nurses in Egypt is critical to ensure quality of care for patients. Issues such as salary, staffing and cooperation with colleagues deserve specific attention.
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Affiliation(s)
- Saverio Bellizzi
- Medical Epidemiologist, Independent Consultant, Geneva, Switzerland.
| | - Susanna Padrini
- A.I.S.P.O. Associazione Italiana per la Solidarietà tra i Popoli, Milan, Italy
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Simonetti M, Cerón C, Galiano A, Lake ET, Aiken LH. Hospital work environment, nurse staffing and missed care in Chile: A cross-sectional observational study. J Clin Nurs 2021; 31:2518-2529. [PMID: 34723415 DOI: 10.1111/jocn.16068] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/18/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To characterise the problem of missed nursing care in Chilean hospitals and to test associations with hospital organisational variables. BACKGROUND Missed nursing care is a common problem in different countries, but it has not been studied in Chile. DESIGN Multihospital cross-sectional study (Supplementary file 1: STROBE guideline). METHODS Study population of 45 adult high-complexity hospitals and 1853 registered nurses (RN) working on medical-surgical units. Primary data were collected through a nurse survey. Nurses reported, out of a list of nursing care activities, the ones left undone during their last shift. The main independent variables were the work environment, measured through the Practice Environment Scale of the Nursing Work Index, patient-to-nurse ratios and RN skillmix. Adjusted logistic regression analyses were used to test associations, accounting for clustering of nurses working in the same hospital. RESULTS The hospital response rate was 88.9% and, for nurses, 88.1%. The mean patient-to-nurse ratio was 14.5 (range 6-23). The average skillmix was 31% RN. Eighty-six percent of nurses missed at least one activity. The activities most frequently missed included patient education, comforting patients and surveillance. The adjusted model showed a significant association between the work environment, staffing ratios and missed care. The RN skillmix was not associated. CONCLUSIONS Missed care is highly prevalent problem in Chilean hospitals. Clinical activities were the least missed. It is necessary to improve work environments and reduce the number of patients per nurse to improve the safety and quality of care. RELEVANCE FOR CLINICAL PRACTICE The study results are relevant since they provide new data to Chile. Better work environments and adequate human resources are modifiable factors that can be addressed from a managerial perspective, with low-cost strategies to effectively reduce missed care and improve safety and quality.
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Affiliation(s)
- Marta Simonetti
- Universidad de los Andes, Chile, Escuela de Enfermería, Chile
| | - Consuelo Cerón
- Universidad de los Andes, Chile, Escuela de Enfermería, Chile
| | | | - Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Pennsylvania, USA
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Pennsylvania, USA
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Labrague LJ, Al Sabei S, Al Rawajfah O, AbuAlRub R, Burney I. Interprofessional collaboration as a mediator in the relationship between nurse work environment, patient safety outcomes and job satisfaction among nurses. J Nurs Manag 2021; 30:268-278. [PMID: 34601772 DOI: 10.1111/jonm.13491] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND As an important organisational feature, the nurse work environment has been associated with increased work effectiveness, reduced patient safety issues and improved care quality. However, the mechanism underlying this association remains unexplored. AIM This study aims to assess the mediating role of interprofessional collaboration in the relationships between nurse work environment, select patient safety outcomes and job satisfaction. METHODS This cross-sectional, descriptive study used five standardized scales and included 881 clinical nurses employed in select teaching hospitals in Oman. RESULTS Nurses who worked in teaching hospitals in Oman perceived their work environment as highly favourable. Nurse work environment was directly and indirectly associated with nurse-assessed quality of care, adverse patient events and job satisfaction, through interprofessional collaborations. CONCLUSION Findings of the study suggest that enhancing nurse work environments can be a potential strategy to foster interprofessional collaboration and improve job satisfaction and patient safety outcomes. IMPLICATIONS FOR NURSING MANAGEMENT Organisational strategies to improve patient safety outcomes and job satisfaction in nurses can be facilitated by improving nurses' work conditions and enhancing interprofessional collaboration through supportive leadership, theory-driven approaches, obtaining hospital accreditation/certification and relevant workplace policies.
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Affiliation(s)
- Leodoro J Labrague
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.,Adjunct Faculty, Graduate School, St. Paul University Philippines, Tuguegarao, Philippines
| | - Sulaiman Al Sabei
- Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Omar Al Rawajfah
- Adult Health and Critical Care Department, College of Nursing, Sultan Qaboos University, Muscat, Oman.,College of Nursing, Al al-Bayt University, Mafraq, Jordan
| | - Raeda AbuAlRub
- Community and Mental Health Department, College of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Ikram Burney
- Department of Medicine, Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
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Gurková E, Bartoníčková D, Mikšová Z. Nursing work environment and unfinished nursing care in hospital settings - a scoping review. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2021. [DOI: 10.15452/cejnm.2021.12.0015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Gurková E, Mikšová Z, Šáteková L. Missed nursing care in hospital environments during the COVID-19 pandemic. Int Nurs Rev 2021; 69:175-184. [PMID: 34433226 PMCID: PMC8653289 DOI: 10.1111/inr.12710] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 08/02/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID-19 pandemic. AIMS The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID-19 pandemic. METHODS A cross-sectional study was used. The RANCARE guideline and STROBE checklist were followed for reporting in the study. The sample consisted of 371 nurses from four acute care hospitals. The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data. The data were analyzed using multiple linear and logistic regression analyses. RESULTS Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care. Prevalence estimates of missed care in Czech acute care hospitals during the COVID-19 pandemic was predicted from the overtime work, the nurses' perception of the "Nursing foundations for the quality of care," and their satisfaction with their current position. CONCLUSIONS Missed nursing care could be mitigated by improving the nurses' work environment. Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care. IMPLICATIONS FOR NURSING POLICY Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses' concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers.
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Affiliation(s)
- Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Zdeňka Mikšová
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Lenka Šáteková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
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Andersson I, Bååth C, Nilsson J, Eklund AJ. A scoping review-Missed nursing care in community healthcare contexts and how it is measured. Nurs Open 2021; 9:1943-1966. [PMID: 34033697 PMCID: PMC9190696 DOI: 10.1002/nop2.945] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 04/16/2021] [Accepted: 04/28/2021] [Indexed: 11/28/2022] Open
Abstract
Aim To examine the extent and nature of missed nursing care in elderly care in community healthcare contexts from the perspective of healthcare staff, and to identify instruments used to measure missed nursing care and the content of these instruments. Design Scoping review. Methods Searches were conducted in the CINAHL, PubMed, Scopus and Google Scholar databases in March 2020. The selection process followed the PRISMA flow diagram. Results Sixteen research papers were found from nine countries. The instruments used in the studies were Basel Extent of Rationing of Nursing Care for nursing homes (BERNCA‐NH), modified MISSCARE survey and study‐specific instruments or items. The item content differed, as did the number of items, which was between one and 44. The studies reported values for missed nursing care, as well as described reasons for and/or the relation between missed nursing care and organization, working climate and patient outcomes.
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Affiliation(s)
- Ingrid Andersson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
| | - Carina Bååth
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Health and Welfare, Østfold University College, Halden, Norway
| | - Jan Nilsson
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden.,Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Anna Josse Eklund
- Department of Health Sciences, Faculty of Health, Science, and Technology, Karlstad University, Karlstad, Sweden
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Huang X, Wang L, Dong X, Li B, Wan Q. Effects of nursing work environment on work-related outcomes among psychiatric nurses: A mediating model. J Psychiatr Ment Health Nurs 2021; 28:186-196. [PMID: 32557979 DOI: 10.1111/jpm.12665] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 05/20/2020] [Accepted: 06/03/2020] [Indexed: 12/12/2022]
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The shortage of psychiatric nurses has become a focus problem attracting widespread concern. And the continuous improvement of quality of psychiatric care has always been a priority in psychiatric units. Previous studies about nurses from general hospitals indicated nursing work environment was a key factor affecting work-related outcomes, but little attention was paid to psychiatric nurses and few studies focused on the five specific dimensions of nursing work environment. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Nurse participation in hospital affairs was the dimension with the highest proportion of participants dissatisfied. Nursing work environment and all its five dimensions had significant effects on work-related outcomes, which were partly mediated by work engagement. For nurse-perceived quality of care, collegial nurse-physician relations showed the largest effect; while for turnover intention, the two dimensions of nurse participation in hospital affairs and nursing foundations for quality of care showed larger effects. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Corresponding measures should be taken to improve nursing work environment, especially in the aspect of nurse participation in hospital affairs by promoting nurses' ability to participate, arousing their motivation to participate and offering them more opportunities to participate. Harmonious collegial relationship should be built by creating an atmosphere of equality, respect and collaboration, and enhancing the communication between doctors and nurses. Nursing foundations for quality of care need to be further improved through setting appropriate rules and regulations to ensure the quality of care and offering more opportunities to support nursing staff's growth and development. ABSTRACT: Introduction With the increasing demand for high-quality psychiatric care, it is imperative to improve psychiatric nurses' work engagement and work-related outcomes. Nursing work environment has been identified as a protective factor in non-psychiatric nurses, but little was known about psychiatric nurses. Aims To identify the situation of nursing work environment, work engagement, nurse-perceived quality of care and turnover intention among psychiatric nurses, and examine the relationship among them. Methods A cross-sectional design was adopted. Questionnaire investigation was implemented among psychiatric nurses from 43 clinical units. Structural equation modelling and path analysis were used to examine the causal relationship among variables. Results The results showed 19.06% of participants were not satisfied with the overall work environment and 24.34% were not satisfied with the dimension of nurse participation in hospital affairs. Hypothesis testing results indicated that nursing work environment and its five dimensions had positive effects on nurse-perceived quality of care and negative effects on turnover intention, which were both partly mediated by work engagement. Discussion Supportive nursing work environment could improve nurses' work engagement, enhance nurse-perceived quality of care and reduce nurses' turnover intention. Implications for Practice Continuous efforts should be paid to the improvement of nursing work environment in psychiatric hospitals.
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Affiliation(s)
- Xiuxiu Huang
- School of Nursing, Peking University, Beijing, China
| | - Limin Wang
- School of Nursing, Peking University, Beijing, China
| | - Xu Dong
- School of Nursing, Peking University, Beijing, China
| | - Bei Li
- School of Nursing, Peking University, Beijing, China
| | - Qiaoqin Wan
- School of Nursing, Peking University, Beijing, China
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Jarošová D, Gurková E, Zeleníková R, Plevová I, Janíková E. Hospital and unit variables of missed nursing care in acute care hospitals: A cross-sectional study. J Clin Nurs 2021; 30:1099-1110. [PMID: 33434291 DOI: 10.1111/jocn.15655] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 11/23/2020] [Accepted: 12/31/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To investigate hospital, unit and staff variables as the correlates of missed nursing care (MNC) in Czech hospitals. BACKGROUND There is a considerable variability in patterns of MNC across different hospital, unit and staff characteristics. DESIGN A cross-sectional study was conducted. The STROBE guidelines for reporting observational studies were followed for reporting of the research study. METHODS A sample of 513 nurses working in nine acute care hospitals was recruited. MNC activities were measured with the MISSCARE Survey. Data were analysed using descriptive statistics and univariate logistic regression. RESULTS Type of unit was confirmed as a significant predictor of MNC. Staff characteristics (nurses' work position, level of education and perceived adequacy of unit staff) and hospital variables did not contribute significantly to MNC. CONCLUSIONS The study replicated the patterns of MNC across different conceptual approaches. MNC was influenced by work environment characteristics rather than individual staff variables. RELEVANCE TO CLINICAL PRACTICE The results of this research showed that missed nursing care is influenced by work environment characteristics rather than individual staff variables.
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Affiliation(s)
- Darja Jarošová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Ilona Plevová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Eva Janíková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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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.
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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
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Longhini J, Papastavrou E, Efstathiou G, Andreou P, Stemmer R, Ströhm C, Schubert M, de Wolf-Linder S, Palese A. Strategies to prevent missed nursing care: An international qualitative study based upon a positive deviance approach. J Nurs Manag 2020; 29:572-583. [PMID: 33090604 DOI: 10.1111/jonm.13176] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 11/28/2022]
Abstract
AIM To identify the strategies to prevent missed nursing care (MNC) that can be implemented by nurse managers/directors on a daily basis. BACKGROUND Only few recommendations have been established to date aiming at supporting nurse managers/ directors in preventing MNC. However, several strategies are implemented on a daily basis, suggesting that a body of tacit, practical and wise knowledge is already in place. METHOD(S) An international qualitative descriptive study based on the positive deviance approach conducted in 2019-2020 and reported according to the Consolidated Criteria for Reporting Qualitative Research. A purposeful sample of 35 nurse managers/directors working in hospitals in Cyprus, Italy, Germany and Switzerland was involved. Codes were extracted from each country, and a thematic analysis was performed at the transnational level to identify strategies and interventions preformed to prevent MNC. RESULTS Eight strategies and 22 interventions, mainly with preventive intent and designed at the hospital level, affecting both the processes and the structural dimensions, have been reported as effective in preventing MNC. CONCLUSION Nurse leaders are involved daily in implementing strategies to minimise MNC at the nursing and at the hospital system levels, integrated with each other. IMPLICATIONS FOR NURSING MANAGEMENT Preventing MNC should be a core value of the entire hospital, and not merely a nursing issue. Therefore, complex interventions at the system level are required.
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Affiliation(s)
- Jessica Longhini
- Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy
| | - 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
| | - Alvisa Palese
- Department of Medical Sciences, School of Nursing, University of Udine, Udine, Italy
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Lake ET, Riman KA, Sloane DM. Improved work environments and staffing lead to less missed nursing care: A panel study. J Nurs Manag 2020; 28:2157-2165. [PMID: 32017302 PMCID: PMC7590500 DOI: 10.1111/jonm.12970] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 01/24/2020] [Accepted: 01/30/2020] [Indexed: 11/28/2022]
Abstract
AIM To document how changes in the hospital work environment and nurse staffing over time are associated with changes in missed nursing care. BACKGROUND Missed nursing care is considered an indicator of poorer care quality and has been associated with worse patient care experiences and health outcomes. Several systematic reviews of cross-sectional studies report that nurses in hospitals with supportive work environments and higher staffing miss less care. Causal evidence demonstrating these relationships is needed. METHODS This panel study utilized secondary data from 23,650 nurses surveyed in 2006 and 14,935 surveyed in 2016 in 458 hospitals from a four-state survey of random samples of licensed nurses. RESULTS Over the 10-year period, most hospitals exhibited improved work environments, better nurse staffing and more missed care. In hospitals with improved work environments or nurse staffing, the prevalence and frequency of missed care decreased significantly. The effect on missed care of changes in the work environment was greater than that of nurse staffing. CONCLUSIONS Changes in the hospital work environment and staffing influence missed care. IMPLICATIONS FOR NURSING MANAGEMENT Modifications in the work environment and staffing are strategies to mitigate care compromise. Nurse managers should investigate work settings in order to identify weaknesses.
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Affiliation(s)
- Eileen T Lake
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kathryn A Riman
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Douglas M Sloane
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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Zeleníková R, Jarošová D, Plevová I, Janíková E. Nurses' Perceptions of Professional Practice Environment and Its Relation to Missed Nursing Care and Nurse Satisfaction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113805. [PMID: 32471133 PMCID: PMC7312939 DOI: 10.3390/ijerph17113805] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 12/14/2022]
Abstract
The professional practice environment is a factor that can have a significant impact on missed nursing care. The study aimed to find a relationship between nurses’ perceptions of their professional practice environment and missed nursing care and job satisfaction. An additional aim was to find differences in nurses’ perceived rating of the professional practice environment according to hospital location and job position. A descriptive correlational study was performed. The sample included 513 general and practical nurses providing direct care in nine Czech hospitals. The Revised Professional Practice Environment scale and the Missed Nursing Care (MISSCARE) survey were used to collect data. The professional practice environment was most correlated with satisfaction with the current position (0.4879). The overall score of missed care correlated most strongly with the subscale “staff relationships” (−0.2774). Statistically significant differences in the rating of two subscales, “control over practice” and “cultural sensitivity”, were found between nurses from hospitals in district capitals and those from hospitals in smaller cities. Statistically significant differences in the rating of the “leadership and autonomy in clinical practice” and “teamwork” subscales were found between general nurses and practical nurses. The professional practice environment is related to nurse satisfaction and missed nursing care.
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Campbell CM, Prapanjaroensin A, Anusiewicz CV, Baernholdt M, Jones T, Patrician PA. Variables associated with missed nursing care in Alabama: A cross‐sectional analysis. J Nurs Manag 2020; 28:2174-2184. [DOI: 10.1111/jonm.12979] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/08/2020] [Accepted: 02/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | | | | | - Marianne Baernholdt
- School of Nursing University of North Carolina at Chapel Hill Chapel Hill North Carolina
| | - Terry Jones
- School of Nursing Virginia Commonwealth University Richmond Virginia
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