Factors influencing why nursing care is missed

Blackman, Ian; Henderson, Julie; Willis, Eileen; Hamilton, Patricia; Toffoli, Luisa; Verrall, Claire; Abery, Elizabeth; Harvey, Clare

doi:10.1111/jocn.12688

Cited by 128 publications

(131 citation statements)

References 26 publications

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“…The Cypriot nurses for example, were all RNs. Despite this, previous research in the field in each country (Blackman et al., ; Palese et al., ; Papastavrou et al., ), have documented similar frequencies and types of missed nursing care adding validity to findings from this study.…”

Section: Limitationssupporting

confidence: 68%

“…Lastly, cultural factors and habits in degree of compliance toward protocols or guidelines, as well as moral attitude, may have an influence here. Lower levels of missed care in Australia may reflect better staffing ratios due to greater protection from the global financial crisis than Italy or Cyprus, despite staffing levels consistently being identified as a factor in missed care in Australia (Blackman et al., ; Willis et al., ).…”

Section: Discussionmentioning

confidence: 99%

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Predicting variations to missed nursing care: A three-nation comparison

et al. 2017

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Aims To measure and model Australian, Cypriot and Italian nurses’ beliefs about what care is missed and how frequently it occurs within their settings. Background This study expands on previous MISSCARE research but now applies and predicts missed care within three countries. Methods Multivariate analysis was performed to estimate 1,896 nurses’ consensus scores about missed care activities based on Alfaro‐Lefevre's conceptual framework of care priorities. Results Five latent variables have direct predictor effects on missed care frequencies. Another four variables including the nurses’ age, highest qualifications, absenteeism rate and workplace type, contributed to explaining the overall variance of missed care scores. The nurses’ gender had no influence on missed care. Conclusion Cross country comparisons of missed nursing care allow for a more refined identification of strategies for remediation for both managers and clinicians. Implications for Nursing Management Reliable consensus estimates about the types and frequencies of missed care can be scaled with variables identified to predict missed care across three different countries. Comparative international studies build on the foundations for understanding missed care in terms of nursing practices, policies and related social policies.

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Section: Limitationssupporting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Predicting variations to missed nursing care: A three-nation comparison

et al. 2017

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“…medication, equipment and supplies) is more likely to contribute to missed care in metropolitan settings and in hospitals. Blackman et al (2015) demonstrated that lack of access to resources intensified the work, as it extended the steps necessary to complete it such as going to another ward to find the equipment or having to make a trip to the pharmacy. Staffing issues and work intensification were identified across all settings with rural nurses significantly more likely to identify lack of assistive staff as contributing to missed care.…”

mentioning

confidence: 97%

Work intensification as missed care

Willis

Henderson

Hamilton

et al. 2015

Labour & Industry: a journal of the social and economic rel

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Work intensification is assumed to incorporate either longer working hours or a quickening of the pace or speed of work. In this paper, we argue that 'missed care' is a proxy for work intensification or work effort in nursing. Using Kalisch's MISSCARE survey tool, with modifications to suit the South Australian context we surveyed 354 registered and enrolled nurses between October and December 2012. Survey participants were recruited through the Australian Nursing and Midwifery Federation (SA Branch). The MISSCARE survey tool presents participants with a 5-point scale where 1 is never omitted care and 5 is always omitted care. Survey findings suggest that the tasks most often missed are ambulation of patients and mouth care. Tasks lest likely to be missed are blood glucose monitoring; hand washing; IV/central line care and providing PRN medication within 15 minutes. These findings suggest that when nurses are forced to ration care, priority is given to clinical tasks that will impact on immediate patient outcomes. In identifying the reasons why they missed care, nurses reported that while staffing often appeared adequate, sudden and unexpected rises in patient volume, heavy admissions and discharges, and inadequate numbers of staff or clerical support were key indicators of missed care. These unpredictable events resulted in an increase in work intensity and pace that was independent of extended working hours or overtime. We argue that one of the outcomes of work intensification is missed care.

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“…The role of nurses is relegated to tasks that complement medical tasks and therefore, the remainder of nursing care and other professional services are much harder to provide (Alberdi & Cuxart 2005). As Blackman's (2015) research suggests, as nurses' work intensifies, they have less time to provide care. Moreover, the fact that students aren't surprised by how little time nurses dedicate to care and by how much they dedicate to other tasks could be interpreted as evidence of how little importance they attribute to care (Fajardo & Germán 2004).…”

Section: Discussionmentioning

confidence: 99%

Contradictory views of nursing care among students at the end of their nursing education

Marañón

Pera

2016

Journal of Advanced Nursing

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Aim To understand how nursing students at the end of their nursing education view nursing care. Background Although care is understood as the essence of nursing, it is often difficult for nurses to provide care, which demonstrates a contradiction between theory and practice. Moreover, it is unknown to what extent this contradiction is transmitted to future nursing professionals or how they view nursing care and its practice. Design Qualitative ethnographic research. Methods The fieldwork was conducted between December 2010 ‐ May 2012 in a university nursing school in Barcelona and two centres where students carry out most of their practical education. The data collection techniques were participant observation and focus groups. A thematic analysis was used. Results The students demonstrated contradictory views of nursing care. On one hand, they voiced a more theoretical, official definition where care is considered the core of the profession. On the other hand, they also expressed a view where the provision of care is not nurses’ principal daily activity, a fact that did not surprise them. Students interpreted caring as an activity that has low value and that can be transferred unproblematically to other professionals. Conclusion The contradictory views of care reveal a problem in the transmission of the definition of nursing to new generations of professionals and reflect a problematic professional reality where there is dissonance between how nursing is defined and how it is carried out in practice.

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Factors influencing why nursing care is missed

Abstract: 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.

Cited by 128 publications

References 26 publications

Predicting variations to missed nursing care: A three-nation comparison

Predicting variations to missed nursing care: A three-nation comparison

Work intensification as missed care

Contradictory views of nursing care among students at the end of their nursing education

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