These Australian findings not only contribute to other international studies that identify why nursing care is omitted, it provides a framework for why reported episodes of missed care can be predicted and subsequently addressed.

Primary schools are identified as being in a primary position to offer nutrition education. Moreover, primary schools can offer an environment which is conducive to the promotion of healthy eating while influencing eating behaviours of children to benefit their health, well-being and academic development and performance. School canteens are one area where a healthy ethos can be encouraged and within Australia, canteens have been the target of recommended or mandated healthy eating state government policies. This is comparable to other Australian health policies mandated in schools in an effort to support good nutrition and physical health among students. Using a qualitative case study approach, this article discusses the implementation of the ‘Right Bite Healthy Food and Drinks Strategy for South Australian Schools and Preschools’ (Right Bite). The case study was undertaken in two primary schools to gain a thorough and in-depth investigation of emerging issues regarding the school canteen and used focus group and face-to-face interviews as well as observation. The data collected were coded and analysed into themes. Respondents claimed that Right Bite had merit although barriers such as: resistance from parents and children to purchase healthy options, difficulties associated with serving and preparing fresh food at school, inadequate canteen facilities, and counteracting heavy marketing of unhealthy foods to children impeded implementation. While Right Bite encourages South Australian school children to make better choices through education and support so as to improve their health, well-being and academic performance, more support must be provided to schools for greater uptake and implementation of policy.

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This article examines missed care through dialogues examining the perceptions of nurses in regard to missed care occasions. Using a critical discourse analysis (CDA), the study explores the truth claims of participants who describe the challenges they encounter in daily attempts to deliver what they consider effective patient care. These are compared to the mandates of state and organisational policy prescribing clinical practice. The boundaries of tension that are expressed by nurses within the milieu of missed care are explored through in-depth interviews. CDA is interested in social organisation and the interplay of people's activities within it, the focus being on how they construe and internalise such activity. Nurses' perceptions and realities become central to any investigation because they are often organised by more than their own intentions or motivations, with influences such as professional standards or organisational rules subconsciously locating their reality. Instead of identifying occasions of omitted care, nurses spoke of constraints related to budget, staffing, skill mix and mandated policy as constraining their ability to complete care activities. Factors emerged that suggest that missed care is the consequence of routinised and standardised practice, cited as cost effective care, at the expense of professional autonomy.