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Fang S, Zhao Y, Gao S, Sun J, Song D, Wu Y, Zhong Q, Sun J. 'Implicit rationing of nursing care processes'-Decision-making in ICU nurses' experiences: A qualitative study. Nurs Crit Care 2024. [PMID: 39011651 DOI: 10.1111/nicc.13127] [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: 02/18/2024] [Revised: 06/10/2024] [Accepted: 06/30/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Implicit rationing of nursing care is defined as the withholding of necessary nursing measures for patients because of a lack of nursing resources. However, no studies have explored the experience of decision-making about implicit rationing of nursing care in an intensive care unit (ICU). AIM To explore the process of ICU nurses' decisions and judgement based on the conceptual framework of implicit rationing of nursing care. STUDY DESIGN A qualitative study was undertaken between June 2020 and September 2020. The data collection methods were participative observation and interview. Eighteen ICU nurses participated in interviews. A thematic analysis was performed for the data analysis. RESULTS The following five themes emerged: assessment of the condition and nature of nursing and time taken; strategies for setting personal priorities; plan implementation under mitigation strategy; existing nursing in reality; evaluation of the implementation of implicit rationing care. Nurses choose different strategies during plan implementation. CONCLUSIONS In the absence of explicit guidelines on rationing nursing care, nurses often rely on intuitive and situational decision-making processes for setting priorities. Given the vulnerability of ICU patients and the absence of family caregivers, nurses bear a heightened ethical responsibility to provide care. Establishing a positive nursing culture is essential. It is both reasonable and effective to organize work by accurately quantifying workload, improving staffing levels and optimizing scheduling methods. These themes align with the decision-making process outlined in the conceptual framework and offer fresh perspectives. RELEVANCE TO CLINICAL PRACTICE Nurses have a greater responsibility to provide care in an ethical manner and to increase awareness of the importance of holistic nursing care for the patient, that is to raise awareness of the importance of care that is often missed. Nurses actively adopt strategies to reduce implicit rationing of nursing care, including teamwork, organized nursing, working overtime and ignoring quality. The findings highlight the importance of creating a positive nursing culture that encourages nurses to adopt positive strategies.
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Affiliation(s)
- Shuyan Fang
- School of Nursing, Jilin University, Changchun, China
| | - Yingnan Zhao
- The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Shizheng Gao
- School of Nursing, Jilin University, Changchun, China
| | - Juanjuan Sun
- School of Nursing, Jilin University, Changchun, China
| | - Dongpo Song
- School of Nursing, Jilin University, Changchun, China
| | - Yifan Wu
- School of Nursing, Jilin University, Changchun, China
| | - Qiqing Zhong
- School of Nursing, Jilin University, Changchun, China
| | - Jiao Sun
- School of Nursing, Jilin University, Changchun, China
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Li J, Li J, She Z, Guo L, Gu S, Lu W. Turnover intention and its related factors of clinical research coordinator in Hunan, China: a cross-sectional study. Sci Rep 2024; 14:16054. [PMID: 38992077 PMCID: PMC11239666 DOI: 10.1038/s41598-024-66960-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 07/05/2024] [Indexed: 07/13/2024] Open
Abstract
To explore the related factors of turnover intention in clinical research coordinators (CRCs) and assess the mediating effects of professional identity on the association between job burnout and turnover intention. In China, CRC has become increasingly common among clinical trial teams in recent years. However, limited published research focused on the status of turnover intention in CRCs. We invited all the 220 CRCs currently working at Hunan Cancer Hospital located in Changsha city in the central south of China from March to June 2018. Participants were asked to complete structured questionnaires regarding basic demographic information, job burnout, professional identity and turnover intention. A total of 202 participants were included in this study, with a response rate of 91.82%. The main reason for turnover intention among CRCs was human resources, followed by communications, management and material resources (per item score in each dimension: 2.14 vs. 2.43 vs. 2.65 vs. 2.83). All the correlations among job burnout, professional identity and turnover intention were statistically significant, with coefficients ranging from -0.197 to 0.615. Multiple liner regression analysis showed that older age, longer workhours per week, and lower level of professional identity were associated with the prevalence of turnover intention among CRCs. Besides, the association between job burnout and turnover intention was fully mediated by professional identity. This study revealed the status and causes of turnover intention among Chinese CRCs. Effective measures on decreasing working time and improving professional identity should be taken in order to reduce CRCs' turnover intention.
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Affiliation(s)
- Juan Li
- Hunan Cancer Hospital, Changsha, Hunan, China
| | - JinHua Li
- Hunan Cancer Hospital, Changsha, Hunan, China
| | - ZhengDi She
- Hunan Cancer Hospital, Changsha, Hunan, China
| | - LiWen Guo
- Hunan Cancer Hospital, Changsha, Hunan, China
| | - ShanZhi Gu
- Hunan Cancer Hospital, Changsha, Hunan, China.
| | - Wen Lu
- Hunan Cancer Hospital, Changsha, Hunan, China.
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Nazari AM, Borhani F, Zare-Kaseb A, Zafarnia N. The relationship between nurses' moral competency and missed nursing care: a descriptive-correlational study. BMC Nurs 2024; 23:388. [PMID: 38844989 PMCID: PMC11155051 DOI: 10.1186/s12912-024-02058-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Accepted: 06/03/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND When any aspect of patient care is overlooked or delayed, it is known as Missed Nursing Care (MNC), leading to adverse events such as medication errors, infections, increased mortality rates, and poor prognosis. Moral competence is crucial for clinical nurses as it guarantees high-quality patient care in nursing practice. Thus, this study aimed to investigate the correlation between moral competencies and MNC among nurses. METHODS This study was conducted with a descriptive-correlational design. The participants in the study were nurses who were currently enrolled at Shahid Beheshti University of Medical Sciences. In order to recruit nurses for the study, a convenience sampling method was implemented. The study tools were completed by a total of two hundred nurses. Research tools included a demographic questionnaire, the Moral Competence of Clinical Nurses Questionnaire, and the Kalisch and Williams Missed Nursing Care (MISSCARE) survey. ETHICAL CONSIDERATION This study was approved by the Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences. RESULTS The mean scores of moral competencies and MNC were 151.83 ± 12.60 and 42.71 ± 9.38, respectively. In other words, descriptive statistics showed that the moral competence score was more than 75%, and the MNC score was less than 50%. Also, there was a significant negative correlation between the total scores of moral competencies and MNC (r = -0.38, p < 0.001), indicating that more moral competence was correlated with lower levels of MNC. CONCLUSION The study revealed a negative correlation between nurses' moral competence and MNC, suggesting that enhancing moral competence could reduce MNC. To reduce MNC occurrences, hospitals, and organizations should prioritize moral competency, according to our research.
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Affiliation(s)
- Amir Mohamad Nazari
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fariba Borhani
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Akbar Zare-Kaseb
- Student Research Committee, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Niloofar Zafarnia
- Educational Development Center, Kerman University of Medical Sciences, Kerman, Iran
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Peng M, Saito S, Mo W, Guan H. Why do nurses miss nursing care? A qualitative meta-synthesis. Jpn J Nurs Sci 2024; 21:e12578. [PMID: 37987226 DOI: 10.1111/jjns.12578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/02/2023] [Accepted: 11/06/2023] [Indexed: 11/22/2023]
Abstract
AIM The aim of this qualitative meta-synthesis was to discover the factors impacting on missed nursing care of nurses through systematic thinking. BACKGROUND Although nurses are responsible for high-quality care, missed nursing care is common, endangering patient safety. Understanding of the causes related to missed nursing care could help nursing managers improve the quality of nursing care. DESIGN A qualitative meta-synthesis guided by the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). METHODS As a method designed to contribute to knowledge development, meta-synthesis allows for integration of qualitative study findings using thematic synthesis. Six databases were searched up to October 2021; nine studies met the inclusion and quality assessment criteria and meta-synthesis were conducted. RESULTS Three themes related to the causes why nurses missed nursing care were found. The themes included intrinsic resources (professional and ethical values, ambiguous nurse role, prioritization, education system, and knowledge), system structure (staff and resources shortage, heavy workload but limited time, and organizational management failure), and social environment (communication, working relationship and skill mix, and inappropriate ward layout). CONCLUSION The phenomenon of missed nursing care is a global tissue, with variations in its elements but also notable similarities. Meta-synthesis provides evidence of intrinsic and extrinsic factors that contribute to missed nursing care. RELEVANCE TO CLINICAL PRACTICE Recognizing and understanding the causes of missed nursing care is essential for nursing managers to ensure patient safety and the provision of high-quality care.
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Affiliation(s)
- Mengyun Peng
- School of Nursing, Soochow University, Suzhou, China
- Graduate School of Health Sciences, Okayama University, Okayama, Japan
| | - Shinya Saito
- Graduate School of Health Sciences, Okayama University, Okayama, Japan
| | - Wenping Mo
- Graduate School of Medicine, Division of Health Sciences, Osaka University, Osaka, Japan
| | - Hong Guan
- Department of Nursing, The Third Hospital of Dalian Medical University, Dalian, China
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Amrolahi-Mishavan F, Emami-Sigaroudi A, Jafaraghaee F, Shahsavari H, Maroufizadeh S, Babaeipour-Divshali M. Exploring Factors affecting Missed Nursing Care in Cardiovascular Care Units: A Qualitative Study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2024; 29:133-139. [PMID: 38333349 PMCID: PMC10849278 DOI: 10.4103/ijnmr.ijnmr_133_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 02/10/2024]
Abstract
Background Cardiovascular care units are among the most crucial departments in any healthcare system. In these units, nurses play the most pivotal roles, and the quality of nursing care is essential; missing certain aspects of care can have irreversible adverse effects on patient health. This qualitative study aims to investigate the factors influencing Missed Nursing Care (MNCs) based on the experiences of nurses and patients in cardiovascular care units. Materials and Methods This qualitative study utilized the conventional content analysis approach to explore the factors affecting MNCs in cardiovascular care units. Data were collected between December 2021 and September 2022 through in-depth, semi-structured individual interviews with 11 participants selected through purposive sampling. Data analysis followed the five-step method proposed by Graneheim and Lundman. Results The analysis revealed five main themes: nurse's job characteristics, work-life conflict, nurse's professional competence, the cardiac work environment atmosphere, and organizational management. Conclusions The findings of this study suggest that authorities should consider factors such as understanding the occupational characteristics of nurses when assigning them to cardiovascular care units, providing solutions to mitigate work-life conflicts for nurses, enhancing nurses' professional competence, improving the working environment for nurses, and enhancing the performance and skills of organizational managers.
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Affiliation(s)
- Fatemeh Amrolahi-Mishavan
- Department of Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Abdolhossein Emami-Sigaroudi
- Department of Community Health Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Fatemeh Jafaraghaee
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran
| | - Hooman Shahsavari
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Saman Maroufizadeh
- Department of Biostatistics, School of Health, Guilan University of Medical Sciences, Rasht, Iran
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Heng LMT, Rajasegeran DD, See AMT, Kannusamy P, Lim SH, Aloweni FBAB, Ang SY. Original Research: Nurse-Reported Missed Care and Its Association with Staff Demographics and the Work Environment. Am J Nurs 2023; 123:28-36. [PMID: 37615466 DOI: 10.1097/01.naj.0000978144.33445.5b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
BACKGROUND Nurses have primary responsibility for many of the care processes and interventions intended to improve patients' health during hospital stays. Accordingly, missed nursing care can negatively impact patient safety and lead to negative clinical outcomes. Missed nursing care is standard care that is not completed, incomplete, or seriously delayed. PURPOSE There is scant literature on nurse-reported missed care (NRMC) in Singapore. Identifying the prevalence of, types of, and reasons for missed care, including staff-related factors, is imperative to understanding the implications of missed care and identifying opportunities for improvement. METHODS Ours is a correlation study of NRMC using convenience sampling. Nurses working on all inpatient units in an acute care hospital in Singapore were recruited to complete the MISSCARE survey, a quantitative tool measuring missed nursing care and the reasons for it. Descriptive statistics was applied to analyze demographics, types of NRMC, and reasons for NRMC. The Pearson χ2 test was used to analyze the correlation between demographics and satisfaction variables and NRMC. RESULTS A total of 314 participants out of 1,944 eligible nurses (response rate, 16%) were recruited. The most commonly reported missed care activities were setting up meals for patients who can feed themselves (87.3%), ambulation (70.1%), attending interdisciplinary conferences (64.3%), providing emotional support to patients and/or family (58%), and turning patients every two hours (56.7%). The most cited reasons for missed care were inadequate number of staff (84.4%), caregiver not in unit or unavailable (76.1%), heavy admission and discharge activity (75.5%), urgent patient situations (74.2%), and unexpected rise in patient volume and/or acuity (73.2%). Younger age, greater experience in role and current unit, inadequate staffing and teamwork, low satisfaction with current role and with being a nurse, and planning to leave the current position were factors significantly associated with greater levels of missed care. CONCLUSION This study demonstrated evidence of NRMC and its associated factors within the local setting. In addition to expanding nursing resources, analyzing nursing work processes, providing support for younger nurses, and improving nursing satisfaction are possible mitigating factors in preventing missed care. Strategies targeting workforce and resource management, greater support for new and younger nurses, and job satisfaction should be considered to address missed care.
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Affiliation(s)
- Laura Mun Tze Heng
- Laura Mun Tze Heng is a staff nurse, Darshini Devi Rajasegeran and Siew Hoon Lim are nurse clinicians, Alicia Min Ting See is a senior staff nurse, and Fazila Binte Abu Bakar Aloweni is senior nurse manager, all at Singapore General Hospital, Singapore. Premarani Kannusamy is deputy director and head of nursing, Youth Preventive Services, and head of nursing, Health Promotion Board, Singapore. Shin Yuh Ang is deputy director of nursing innovation, quality and research, Singapore General Hospital, and director of nursing, National Dental Centre, Singhealth, Singapore. Contact author: Darshini Devi Rajasegeran, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Shi XP, Dychangco MEA, Yang XM, Olivar JJR. Development and Validation of the Missed Nursing Care Tool for Pre-Operative Patients with Lung Cancer in China. Patient Prefer Adherence 2023; 17:1451-1465. [PMID: 37350778 PMCID: PMC10284153 DOI: 10.2147/ppa.s413585] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023] Open
Abstract
Introduction Current research suggests that missed nursing care is widespread in preoperative lung cancer patients in China, and preoperative airway management nursing care for lung cancer patients is not standardized. Missed nursing care for preoperative lung cancer patients, on the other hand, is rarely investigated, particularly from the patient's perspective. This study aimed to develop and validate the MISSCARE Survey for pre-operative patients with lung cancer in China. Methods This study generated the preliminary draft of the MISSCARE Survey - Lung Cancer Patient (MS-LCP) and tested its reliability and stability through three rounds of lung cancer resection (494, 50, and 309 cases, respectively). 20 patients and 6 experts determined the face and content validity. EFA and CFA assessed construct and convergent validity. Internal consistency, including Cronbach's alpha, Spearman-Brown reliability, and re-test reliability, was also examined. Results The scale contained 15 items, including specific care, communicative care, timely care, and basic care. KMO was 0.932 (> 0.6), and Bartlett's Test of Sphericity showed P = 0.000 (<0.05). The attribution factor's item loads ranged from 0.765 to 0.853, accounting for 82.20% of the variation. The scale's Cronbach's alpha, Spearman-Brown, and retest reliability were 0.945, 0.879, and 0.824. CFA showed goodness of fit (RMSEA = 0.021, χ2/df = 1.138, GFI = 0.900, AGFI = 0.945, CFI = 0.996, NFI = 0.967, IFI = 0.996). For each dimension, AVE ranged from 0.555 to 0.717 (>0.50) and CR from 0.861 to 0.904 (>0.70). Conclusion The MS-LCP was reliable and valid in this study, making it appropriate for the Chinese lung cancer patient population. This tool is more objective in its presentation of missed nursing care, assisting nursing staff in optimizing nursing procedures before surgery, increasing the implementation of higher-quality tumor care, and promoting the recovery of lung cancer surgery patients.
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Affiliation(s)
- Xin-ping Shi
- The Nursing Department, Henan Provincial People’s Hospital, People’s Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Ma Encarnacion A Dychangco
- Paulinian Leadership Academy, University Research Council, St Paul University Manila, Manila, Philippine
| | - Xu-ming Yang
- Operating Room, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
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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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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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Imam A, Obiesie S, Gathara D, Aluvaala J, Maina M, English M. Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:19. [PMID: 36918941 PMCID: PMC10015781 DOI: 10.1186/s12960-023-00807-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Missed nursing care undermines nursing standards of care and minimising this phenomenon is crucial to maintaining adequate patient safety and the quality of patient care. The concept is a neglected aspect of human resource for health thinking, and it remains understudied in low-income and middle-income country (LMIC) settings which have 90% of the global nursing workforce shortages. Our objective in this review was to document the prevalence of missed nursing care in LMIC, identify the categories of nursing care that are most missed and summarise the reasons for this. METHODS We conducted a systematic review searching Medline, Embase, Global Health, WHO Global index medicus and CINAHL from their inception up until August 2021. Publications were included if they were conducted in an LMIC and reported on any combination of categories, reasons and factors associated with missed nursing care within in-patient settings. We assessed the quality of studies using the Newcastle Ottawa Scale. RESULTS Thirty-one studies met our inclusion criteria. These studies were mainly cross-sectional, from upper middle-income settings and mostly relied on nurses' self-report of missed nursing care. The measurement tools used, and their reporting were inconsistent across the literature. Nursing care most frequently missed were non-clinical nursing activities including those of comfort and communication. Inadequate personnel numbers were the most important reasons given for missed care. CONCLUSIONS Missed nursing care is reported for all key nursing task areas threatening care quality and safety. Data suggest nurses prioritise technical activities with more non-clinical activities missed, this undermines holistic nursing care. Improving staffing levels seems a key intervention potentially including sharing of less skilled activities. More research on missed nursing care and interventions to tackle it to improve quality and safety is needed in LMIC. PROSPERO registration number: CRD42021286897.
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Affiliation(s)
- Abdulazeez Imam
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
- Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK.
| | - Sopuruchukwu Obiesie
- Centre for Evidence Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/11/2022] [Accepted: 08/30/2022] [Indexed: 11/27/2022]
Abstract
AIMS To systematically review the literature on relationships between communication issues and missed nursing care. DESIGN Systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 Statement. DATA SOURCES EMBASE, Web of Science, CINAHL, PubMed and Cochrane databases were comprehensively searched from inception to December 2021. REVIEW METHODS Screening, data extraction and initial quality assessment were conducted independently by two reviewers. The JBI quality assessment tool was used for study appraisal and the certainty of evidence was assessed using the five Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. Discrepancies were settled by consulting a third researcher. RESULTS A total of 18 articles were included. Missed nursing care was common and the status of communication was not optimistic in clinical. Nurses' sociodemographic characteristics and work environment both influenced missed nursing care and communication. Intrateam communication included three parts: doctors-nurses communication, nurses-nurses communication and nurses-patients communication, poor intrateam communication could contribute to missed nursing care. There was an interaction between missed nursing care and communication. CONCLUSION Promoting efficient intrateam communication, to acknowledge the importance of communication factors in reducing the incidence of missed nursing care in clinics is required. Future research can explore the impact of the internal dimension of communication on missed nursing care and consider interventions aimed at nurses' effective communication. IMPACT What problem did the study address? This study offers new evidence that the impact of intrateam communication on missed nursing care. What were the main findings? Effective intrateam communication can reduce the incidence of missed nursing care, there is mutual influence between communication and missed nursing care. Where and on whom will the research have an impact? Policymakers can provide positive interventions on communication problems in different populations (e.g. nurses-patients, nurses-nurses and doctors-nurses) to provide high-quality patient care.
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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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Hernández-Corral S, Serván-Mori E, Benítez-Chavira LA, Nigenda G, Zárate-Grajales RA. Missed nursing care in highly specialized hospitals: A Mexican case study. Int J Health Plann Manage 2022; 37:2997-3005. [PMID: 35723665 DOI: 10.1002/hpm.3501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 04/16/2022] [Accepted: 05/03/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To assess the status of missed nursing care and the reasons for its occurrence in a highly specialised public hospital in Mexico. MATERIALS AND METHODS An observational cross-sectional analysis with data collected from January to June 2019 at the National Institute of Rehabilitation Luis Guillermo Ibarra Ibarra in Mexico City. We assessed missed care and its causes by conducting the MISSCARE survey among 116 nursing professionals selected from a population of 162 nurses. This work presents the estimated rates of missed care-overall and broken down into its four dimensions-as well as the reasons for its occurrence, namely limited labour resources, inadequate material resources and communication problems among work teams. RESULTS The overall score for missed care was 16% (95% CI: 11.84%-20.15%), with the following rates by dimension: 19.48% for basic care, 14.66% for individual needs, 6.47% for patient education and discharge planning, and 4.31% for continuous patient assessment. The main reason cited for missed care was inadequate material resources, followed by limited labour resources and communication problems among work teams. CONCLUSION Basic care and individual needs interventions were the most frequently omitted services, primarily because of inadequate material resources, limited labour resources and communication problems among work teams. An increase in the frequency of missed care can be expected in light of the high demand for health services, particularly as regards labour and material resources, imposed by the SARS-CoV-2 pandemic.
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Affiliation(s)
| | - Edson Serván-Mori
- Center for Health Systems and Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Luis A Benítez-Chavira
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
| | - Gustavo Nigenda
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
| | - Rosa A Zárate-Grajales
- National School of Nursing and Obstetrics, National Autonomous University of Mexico, Mexico City, Mexico
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Wang B, Zou G, Zheng M, Chen C, Teng W, Lu Q. Correlation between the quality of nursing handover, job satisfaction, and group cohesion among psychiatric nurses. BMC Nurs 2022; 21:86. [PMID: 35410223 PMCID: PMC9003974 DOI: 10.1186/s12912-022-00864-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
Background Nursing handovers are a critical component of patient safety. Researchers have performed many primary studies in this field, mainly reporting findings from changes in nursing handover patterns. However, few quantitative studies have explored the factors that influence handover quality. Therefore, this study aimed to investigate the quality of handovers and explore the associations between handover quality, job satisfaction, and group cohesion among psychiatric nurses. Methods This cross-sectional study included 186 registered psychiatric nurses from a Chinese hospital, who responded to the Handover Evaluation Scale, McCloskey/Mueller Satisfaction Scale, and Group Cohesion Scale. Bootstrap analyses were used to evaluate the mediating effect between variables. Results The average item score for handover quality was (5.85 ± 1.14), and job satisfaction and group cohesion could predict the variance of handover quality. Job satisfaction could partially mediate between group cohesion and handover quality, and the value of the mediating effect was 45.77%. Conclusion The quality of psychiatric nursing handovers has enhanced space. Thus, hospital managers should take various measures to strengthen group cohesion and promote job satisfaction, both of which help improve the quality of psychiatric nursing handovers.
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Affiliation(s)
- Bin Wang
- Department of Psychiatric, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, 250000, Shandong, China
| | - Guiyuan Zou
- Department of Psychiatric, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, Jinan, 250014, Shandong, China.
| | - Mei Zheng
- Department of Psychiatric, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, Jinan, 250014, Shandong, China
| | - Chen Chen
- Department of Psychiatric, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, Jinan, 250014, Shandong, China
| | - Weiyu Teng
- Department of Psychiatric, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, Jinan, 250014, Shandong, China
| | - Qinghua Lu
- Department of Psychiatric, Shandong Mental Health Center, Shandong University, 49 Wenhua East Road, Jinan, 250014, Shandong, China
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Imam A, Obiesie S, Aluvaala J, Maina M, Gathara D, English M. Missed nursing care in acute care hospital settings in low-middle income countries: a systematic review protocol. Wellcome Open Res 2022; 6:359. [PMID: 35495089 PMCID: PMC9020529 DOI: 10.12688/wellcomeopenres.17431.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Missed nursing care (care left undone or task incompletion) is viewed as an important early predictor of adverse patient care outcomes and is a useful indicator to determine the quality of patient care. Available systematic reviews on missed nursing care are based mainly on primary studies from developed countries, and there is limited evidence on missed nursing care from low-middle income countries (LMICs). We propose conducting a systematic review to identify the magnitude of missed nursing care and document factors and reasons associated with this phenomenon in LMIC settings. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). We will conduct literature searching across the Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, from inception to 2021. Two independent reviewers will conduct searches and data abstraction, and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be determined using the Newcastle-Ottawa Scale (NOS). Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals PROSPERO registration number: CRD42021286897 (27 th October 2021).
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Affiliation(s)
- Abdulazeez Imam
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
| | | | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Obregón-Gutiérrez N, Puig-Calsina S, Bonfill-Abella A, Forrellat-González L, Subirana-Casacuberta M. “Care left undone” and quality of care during the COVID-19 pandemic: Influential factors and modulating strategies. ENFERMERÍA CLÍNICA (ENGLISH EDITION) 2022; 32:4-11. [PMID: 35094969 PMCID: PMC8768014 DOI: 10.1016/j.enfcle.2021.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/18/2021] [Indexed: 12/18/2022]
Abstract
Objective To analyze the quality of care provided during the COVID-19 pandemic, identifying what care has been prioritized and factors that have influenced such care. Background Given the need to adapt care due to the pandemic, nurses may have been subjected to factors that have negatively affected them, however it has also been possible to find actions that have enabled nurses to maintain the quality of care provided. Method Exploratory study with a sample of 225 nurses. Data collection was performed using a self-assessment of the care provided, the ‘Care Left Undone’ Scale, and ad hoc questionnaire for demographic variables. Results The mean rate of missed care was 5.76. Significant differences were identified according to age, professional experience, field of specialty and personal and professional strategies. Conclusion Both personal and professional feelings, characteristics, and strategies have an effect in the perception of quality of care provided and missed care during the pandemic.
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Affiliation(s)
- Noemí Obregón-Gutiérrez
- Adjunta a la Dirección Enfermería, Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Departamento de Enfermería, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Salut Puig-Calsina
- Departamento de Enfermería, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Jefa de Área de Enfermería, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Anna Bonfill-Abella
- Departamento de Enfermería, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Enfermera Clínica, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Laura Forrellat-González
- Departamento de Enfermería, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Enfermera Clínica, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Mireia Subirana-Casacuberta
- Departamento de Enfermería, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Directora Enfermera, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain; Grupo de investigación en Metodología, métodos, modelos y resultados en salud y sociales (M3O), Facultad de Ciencias de la Salud y el Bienestar, Centro de Estudios Sanitarios y Sociales (CESS), Universidad de Vic-Universidad Central de Cataluña (UVIC-UCC), Barcelona, Spain.
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Imam A, Obiesie S, Aluvaala J, Maina M, Gathara D, English M. Missed nursing care in acute care hospital settings in low-middle income countries: a systematic review protocol. Wellcome Open Res 2021; 6:359. [PMID: 35495089 PMCID: PMC9020529 DOI: 10.12688/wellcomeopenres.17431.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 02/15/2024] Open
Abstract
Background: Missed nursing care (care left undone or task incompletion) is viewed as an important early predictor of adverse patient care outcomes and is a useful indicator to determine the quality of patient care. Available systematic reviews on missed nursing care are based mainly on primary studies from developed countries, and there is limited evidence on missed nursing care from low-middle income countries (LMICs). We propose conducting a systematic review to identify the magnitude of missed nursing care and document factors and reasons associated with this phenomenon in LMIC settings. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). We will conduct literature searching across the Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, from inception to 2021. Two independent reviewers will conduct searches and data abstraction, and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be determined using the Newcastle-Ottawa Scale (NOS). Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals PROSPERO registration number: CRD42021286897 (27 th October 2021).
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Affiliation(s)
- Abdulazeez Imam
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
| | | | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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Obregón-Gutiérrez N, Puig-Calsina S, Bonfill-Abella A, Forrellat-González L, Subirana-Casacuberta M. ["Care left undone" and quality of care during the COVID-19 pandemic: Influential factors and modulating strategies]. ENFERMERIA CLINICA 2021; 32:4-11. [PMID: 34177254 PMCID: PMC8220938 DOI: 10.1016/j.enfcli.2021.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/18/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To analyze the quality of care provided during the COVID-19 pandemic, identifying what care has been prioritized and factors that have influenced such care. BACKGROUND Given the need to adapt care due to the pandemic, nurses may have been subjected to factors that have negatively affected them, however it has also been possible to find actions that have enabled nurses to maintain the quality of care provided. METHOD Exploratory study with a sample of 225 nurses. Data collection was performed using a self-assessment of the care provided, the 'Care Left Undone' Scale, and ad hoc questionnaire for demographic variables. RESULTS The mean rate of missed care was 5.76. Significant differences were identified according to age, professional experience, field of specialty and personal and professional strategies. CONCLUSION Both personal and professional feelings, characteristics, and strategies have an effect in the perception of quality of care provided and missed care during the pandemic.
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Affiliation(s)
- Noemí Obregón-Gutiérrez
- Director of Nursing. Nursing Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Salut Puig-Calsina
- Nurse Manager, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Anna Bonfill-Abella
- Clinical Nurse, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Laura Forrellat-González
- Clinical Nurse, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Mireia Subirana-Casacuberta
- Chief Nursing Officer Manager. Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain and Research Group on Methodology, Methods, Models and Health and social Outcomes (M3O). Faculty of Health Science and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVIC-UCC).C. Sagrada Família, 7, 08500, Vic, Barcelona, Spain
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Missed Nursing Care in the Postanesthesia Care Unit: A Cross-Sectional Study. J Perianesth Nurs 2021; 36:232-237. [PMID: 33618995 DOI: 10.1016/j.jopan.2020.10.009] [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: 09/12/2020] [Revised: 10/15/2020] [Accepted: 10/18/2020] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to investigate the prevalence, activities, and reasons for missed nursing care in the postanesthesia care unit (PACU) and the effect of intensive care unit (ICU) overflow patients. DESIGN This is a single-center, cross-sectional survey. METHODS Nineteen PACU-registered nurses of a tertiary care hospital participated. Over a 7-month period, participants were asked to complete a validated questionnaire, which included 19 items related to missed nursing care activities and 10 items related to reasons for missed nursing care. χ2 test and 1-way analysis of variance were used for data analysis. FINDINGS Questionnaires (N = 397) were completed. Prevalence of missed nursing care activities was 78.1% and was significantly higher in cases of ICU overflow patients (P < .001). The three most reported missed nursing care activities were "drug preparation, administration, and assessment of effectiveness," "patient surveillance and assessment," and "care associated with pain"; prevalence was significantly higher in cases of ICU overflow patients (P = .036, P = .003, and P = .004, respectively). The three most reported reasons for missed nursing care were "inadequate number of nursing personnel," "unexpected rise in patient volume or acuity," and "heavy admission or discharge activity". CONCLUSIONS The findings indicated missed nursing care was common in the PACU and increased in case of ICU overflow patients. Therefore, missed nursing care needs to be identified and minimized, while the number and length of stay of critically ill patients admitted to the PACU should be limited.
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Du H, Yang Y, Wang X, Zang Y. A cross-sectional observational study of missed nursing care in hospitals in China. J Nurs Manag 2020; 28:1578-1588. [PMID: 32726867 PMCID: PMC7589234 DOI: 10.1111/jonm.13112] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 07/15/2020] [Accepted: 07/22/2020] [Indexed: 01/22/2023]
Abstract
Aim To identify the risk of missed nursing care (MNC), and contributing factors, in Chinese hospitals. Background National reporting of adverse incidents diminishes errors of commission. To further improve service quality and patient safety, MNC should be reduced. Methods An online survey comprising the MISSCARE Survey and the McCloskey/Mueller Satisfaction Scale was conducted with a convenience sample of nurses (n = 6,158) in 34 Chinese hospitals. Results Participants’ mean age was 30.6 (SD = 7.014), and 2.5% were male. The most frequently missed nursing care items were basic care (12.7%–51.8%). The most frequently reported reasons were human resource issues (63.1%–88.2%). Being female, no child, better educated, a manager, permanently employed, no night shift, inadequate friend support and job dissatisfaction influenced the perception of MNC (odds ratio 1.00–4.848). Conclusions MNC often occurred in basic care involving informal caregivers or in surge status due to a sudden increase in workload. Implications for Nursing Management Nurse managers should prioritize effective measures that target delegation competency and mobilization of nurses for flexible repositioning during need.
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Affiliation(s)
- Hongxia Du
- Department of Nursing, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yuanyuan Yang
- School of Nursing, Cheeloo College of Nursing, Shandong University, Jinan, Shandong Province, China
| | - Xiaohong Wang
- Department of Nursing, Jinan Central Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, China
| | - Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China
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