Abstract
BackgroundMissed nursing care (MNC) has been linked to patient harm in a growing body of literature. However, this issue is still not adequately investigated in developing countries. The aim of the study is to measure the extent of missed nursing care, to identify its types, and to determine factors contributing to missed nursing care.MethodsA cross-sectional design was used. The study was conducted among 50 units at 1762-beds teaching Hospital in Alexandria that employs 1211 nurses in inpatient areas. A sample of 553 nurses were interviewed using the MISSCARE and the N4CAST survey. The MISSCARE survey measured the amount of missed nursing care (MNC) that was experienced on the last worked shift by each nurse. The N4CAST survey was used to collect data about level of non-nursing work carried out by nurses and the nurses’ job satisfaction.ResultsThe overall mean score for the missed nursing care was 2.26 ± 0.96 out of 5, with highest mean score attributed to “Planning” and lowest mean score attributed to “Assessment and Vital Signs” (2.64 and 1.96, respectively). Missed nursing care was significantly associated with number of patients admitted and cared for in the last shift and perceived staffing adequacy. Almost all non-nursing care tasks and most of satisfaction elements showed negative weak correlation with overall missed nursing care.ConclusionMissed Nursing Care is common in study hospital which may endanger patient safety. MNC Missed Nursing Care is positively associated with nursing adequacy. There is no association between MNC and neither nurses’ job satisfaction nor non-nursing tasks. Nursing leaders should monitor missed nursing care and the environmental and staffing conditions associated with it in order to design strategies to reduce such phenomena.
Highlights
The term “missed nursing care” (MNC), introduced in 2006 [1], has been defined as “any aspect of required patient care that is omitted or delayed” [2]
Using the objective measures of hours per patient day (HPPD), registered nurse hours per patient day, and skill mix, one study conducted in hospitals in the USA identified HPPD as the only significant predictor of Missed nursing care (MNC) [9], while another study in hospitals in the USA reported that none of the measures was a significant predictor [5], and a third study in two hospitals in the USA reported that these measures were not predictors of patient-reported MNC [10]
Nursing perceived level of adequate staffing was found to be a significant independent predictor in a study conducted in the USA, where those who perceived their staffing as adequate more often reported less MNC [4], while the same measure was not a significant predictor in another study conducted in eight hospitals in Iceland [12]
Summary
The term “missed nursing care” (MNC), introduced in 2006 [1], has been defined as “any aspect of required patient care that is omitted (either in part or in whole) or delayed” [2]. One conducted in 488 hospitals across 12 European countries and the other conducted in 10 acute care hospitals in the USA, concluded that higher patient-tonurse ratio was a significant predictor of MNC [4, 13], while another study reported that a higher patient-tonurse ratio was a significant predictor of less MNC in an Italian medical care setting [6], and a fourth study conducted in Lebanon revealed that the patient-to-nurse ratio was not an independent predictor of MNC [14]. Missed nursing care (MNC) has been linked to patient harm in a growing body of literature. This issue is still not adequately investigated in developing countries. The aim of the study is to measure the extent of missed nursing care, to identify its types, and to determine factors contributing to missed nursing care
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