Nursing care missed in patients at risk of or having pressure ulcers

Abstract

Objective:to determine the nursing care missed as perceived by the nursing staff and its relation with the nursing care missed identified in the assessment of patients at risk of or having pressur ulcers. Method:descriptive correlation study. The participants were 161 nurses and 483 patients from a public hospital. The MISSCARE survey was used in combination with a Nursing Care Assessment Form for Patients at Risk of or having pressure ulcers. For the analysis, descriptive and inferential statistics were used. Results:the nursing staff indicated greater omission in skin care (38.5%), position change (31.1%) and the registration of risk factors for the development of pressure ulcers (33.5%). The nursing care missed identified in the assessment related to the use of pressure relief on bony prominences and drainage tubes interfering in the patient's movements (both with 58.6%) and the use of pneumatic mattresses (57.6%). Conclusion:a high percentage of nursing care missed was found according to the staff's perception. Nevertheless, the assessment of the nursing care missed was much higher. No significant relation was found between both. Therefore, it is a priority to reflect on the importance of objective patient assessments.

Hospital Acquired Pneumonia Prevention Initiative-2: Incidence of nonventilator hospital-acquired pneumonia in the United States

“…Our results found multiple missed care opportunities in the 24 hours before diagnosis of pneumonia. Numerous previous studies have reported that missed fundamental hospital care is linked to poorer patient outcomes, 17,[19][20][21][22][23][24][25] a finding that is also supported by our data.…”

“…18,19 Data from some studies support that a large amount of fundamental care is being missed in U.S. acute care hospitals. 17,[19][20][21][22][23][24][25] Furthermore, missed hospital care in both U.S. and international studies has been linked to numerous harmful outcomes for patients and increased cost for hospitals. 17 Two recent systematic reviews of these therapeutic interventions to prevent pneumonia found that the use of oral care was associated with the most evidence of benefit.…”

Design and psychometric testing of the attitude towards the prevention of incontinence‐associated dermatitis instrument (APrIAD)

“…Skin care is part of fundamental nursing care or care meeting the basic needs of humans, such as nutrition, hydration, sleep, and dignity . However, during the last decade, several studies have determined that skin care is often the subject of missed nursing care . The latter is defined as: “any aspect of required patient care that is omitted (either in part of whole) or delayed” .…”

“…Often, these priorities are focused on “critical” care with immediate result, such as treatment procedures and pain management . The proportion of nurses who reported that skin care was missed during their most recent shift varied between 20.5% and 39.5% . Inadequate skin care is associated with complications, such as pressure ulcers and incontinence‐associated dermatitis (IAD) …”

Ensino sobre segurança do paciente nos cursos de graduação: um estudo bibliométrico [Teaching patient safety in undergraduate courses: a bibliometric study] [Enseñanza sobre la seguridad del paciente en los cursos de pregrado: un estudio bibliométrico]

“…Nesse contexto, o IOM aponta que os profissionais de saúde não são adequadamente preparados para fornecer uma assistência de alta qualidade e segurança aos pacientes. Afirma ainda que educação em saúde necessita de uma grande reformulação, e os profissionais, como membros de uma equipe interdisciplinar, deveriam ser educados para prestar um cuidado centrado no paciente, com ênfase na prática baseada em evidências, abordagens de melhorias de qualidade e informática 5,6 .…”