Association between nurses' breaks, missed nursing care and patient safety in Korean hospitals

Abstract

Aims: To examine the relationship between breaks and patient safety in Korean hospitals and determine the mediating effect of missed nursing care on this relationship. Background: Breaks during working hours can affect patient safety; however, few studies have examined the relationship between breaks and patient safety in hospitals and their findings were conflicting. Methods: A cross-sectional online survey was conducted with 399 nurses in Korean hospitals. Multiple linear regression was used to explore the association between breaks, missed nursing care and patient safety. Model 4 of Hayes's (2018) and bootstrapping analysis were employed to identify the mediating effect of missed nursing care. Results: Average break time per shift was about 15 min; most participants had breaks of less than 30 min. Missed nursing care was a complete mediator of the relationship between breaks and patient safety. Conclusion: Break length has an indirect effect on patient safety, medication errors and falls with injury through missed nursing care. Implications for Nursing Management: More discussion is needed to develop policy and mandatory regulations to ensure sufficient breaks and adequate nurse staffing to reduce missed nursing care and enhance patient safety. K E Y W O R D S accidental falls, medication errors, nursing care, patient safety, rest | 2267 MIN et al. reported missing at least one nursing care activity (Griffiths et al., 2018). Another review reported that most nursing personnel (55%-98%) left at least one task undone during their shifts (Jones et al., 2015). The outcomes of missed nursing care are closely related to patient safety. According to Jones et al. (2015) and Recio-Saucedo et al.'s (2018) studies, missed nursing care affects almost all patient safety outcomes including medication errors, patient falls, nosocomial infections, urinary tract infections, pressure ulcers and patient readmission. It is important to eliminate the well-known predictors of missed nursing care (AHRQ, 2019; Kalisch, Xie, & Ronis, 2013) and identify additional associated factors that can be modified. Based on previous research, the most consistent factors of missed nursing care are insufficient nurse staffing (

A cross‐sectional study of the determinants of missed nursing care in the private sector: Hospital/unit/staff characteristics, professional quality of life and work alienation

“…However, care components stated to be missed most in the related literature may vary. For instance, a study conducted in Korea showed that the most missed MNC components were emotional support and full documentation of the necessary data (Min, Yoon, Hong, & Kim, 2019). This is assumed to be associated with varied nursing care policies across countries or institutions.…”

Effects of Work Environments and Occupational Fatigue on Care Left Undone in Rotating Shift Nurses

“…An actual response rate could not be estimated because the number of nurses who saw the advertisement in the mobile application was unknown. A total of 618 nurses consented to participate in the survey, and 126 nurses did not complete it (nonresponse rate: 20.38%; Min, Yoon, Hong, & Kim, 2019). Therefore, 492 nurses completed the survey, and 488 (effective response rate: 99.19%) valid responses were used in the final analysis.…”

“…Nurses’ occupational fatigue was measured using the Korean version of the Occupational Fatigue Exhaustion/Recovery (OFER‐K) scale (Min et al, 2019). The OFER‐K scale consists of 15 items divided equally into three subscales: acute fatigue (OFER‐AF), inter‐shift recovery (OFER‐IR), and chronic fatigue (OFER‐CF).…”

“…The level of each subscale is divided into low, low/moderate, moderate/high, and high according to quartiles. The OFER scale has been validated for nursing in many countries, including Korea (Fang et al, 2018; Min et al, 2019; Winwood, Lushington, & Winefield, 2006). The previously established OFER‐K scale’s Cronbach’s alpha levels were 0.76 (OFER‐AF), 0.75 (OFER‐IR), and 0.76 (OFER‐CF; Min et al, 2019).…”

“It is really so exhausting”: Exploring intensive care nurses’ perceptions of 24‐hour long shifts

“…A paper reported that 75% of nurses reported missing at least one activity, and 55%-98% reported at least one task undone (Min, Yoon, Hong, & Kim, 2019). These missing activities are closely associated with lower patient safety, including increased nosocomial infection, pressure injuries, medication errors and increased patient admissions and readmissions.…”