Missed nursing care and its influencing factors among neonatal intensive care unit nurses in South Korea: a descriptive study

Abstract

Purpose: Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates’ vulnerabilities. This study examined missed care and its influencing factors among NICU nurses.Methods: Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected.Results: All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was “provide developmental care for the baby”. The most common reason for missed care was “emergency within the unit or deterioration of one of the assigned patients”. The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items.Conclusion: Missed care was affected by nurses’ workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses’ working conditions should be improved to ensure adequate time for nursing activities.

Exploring Missed Nursing Care in the NICU: Perspectives of NICU Nurses in Saudi Arabia’s Eastern Health Cluster

“…For instance, 93.2% of nurses missed providing neonatal developmental care, which was nearly the most frequently missed care, followed by supporting parents emotionally, which has been missed by 88.1% of NICU nurses. Similar to Gathara et al's (2019) [7] and Tubbs-Cooley et al's (2014) [8] findings, Kim and Chae (2022) also claimed that the involvement of parents in neonatal care and parents' education were missed by 83.1% of NICU nurses, which was found to be highly associated with decreased pain control levels and delayed discharge preparation [9]. In contrast with Gathara et al's (2019) study, Kim and Chae's (2022) study showed that assessing vital signs, providing feeding at the prescribed intervals, administering oxygen therapy, and adjusting oxygen concentration were among the least frequently missed nursing care tasks.…”

“…Similar to Gathara et al's (2019) [7] and Tubbs-Cooley et al's (2014) [8] findings, Kim and Chae (2022) also claimed that the involvement of parents in neonatal care and parents' education were missed by 83.1% of NICU nurses, which was found to be highly associated with decreased pain control levels and delayed discharge preparation [9]. In contrast with Gathara et al's (2019) study, Kim and Chae's (2022) study showed that assessing vital signs, providing feeding at the prescribed intervals, administering oxygen therapy, and adjusting oxygen concentration were among the least frequently missed nursing care tasks. A cross-sectional study conducted by Gathara et al (2019) on 216 neonates at six hospitals in Nairobi and Kenya concluded that the average completion rate of nursing tasks was 60%, which could adversely impact neonatal safety and outcomes.…”

“…Part of such a plan should include a general review of the human resources guidelines in terms of nurse salaries, staffing and scheduling, absenteeism, sick leave penalties, and regulations. NICU nurses’ working environments should be improved in order to ensure adequate time for nursing activities [ 6 ].…”

“…In 2022, Kim and Chae reported that missed nursing care is prevalent among NICU nurses in South Korea [ 6 ]. For instance, 93.2% of nurses missed providing neonatal developmental care, which was nearly the most frequently missed care, followed by supporting parents emotionally, which has been missed by 88.1% of NICU nurses.…”

The ramifications of Missing Nursing Care on adverse patient outcomes are profound. Insights gleaned from data offer valuable perspectives on nursing practices and their direct repercussions on patient well-being

“…Missed nursing care presents a global challenge with diverse implications, necessitating an understanding of clinical nurses' experiences (Alireza et al, 2022). Nurses' workload related to medication administration directly influences missed care, particularly in tasks involving developmental care that demand time and patience, often conflicting with prioritizing safety and encountering inadequate working conditions (Soohyun et al, 2022). The repercussions of missed nursing care extend to negative impacts on nurses' health, job…”