Missed nursing care in relation to registered nurses' level of education and self‐reported evidence‐based practice

Abstract

BackgroundPatient safety is one of the cornerstones of high‐quality healthcare systems. Evidence‐based practice is one way to improve patient safety from the nursing perspective. Another aspect of care that directly influences patient safety is missed nursing care. However, research on possible associations between evidence‐based practice and missed nursing care is lacking.AimThe aim of this study was to examine associations between registered nurses' educational level, the capability beliefs and use of evidence‐based practice, and missed nursing care.MethodsThis study had a cross‐sectional design. A total of 228 registered nurses from adult inpatient wards at a university hospital participated. Data were collected with the MISSCARE Survey‐Swedish version of Evidence‐Based Practice Capabilities Beliefs Scale.ResultsMost missed nursing care was reported within the subscales Basic Care and Planning. Nurses holding a higher educational level and being low evidence‐based practice users reported significantly more missed nursing care. They also scored significantly higher on the Evidence‐based Practice Capabilities Beliefs Scale. The analyses showed a limited explanation of the variance of missed nursing care and revealed that being a high user of evidence‐based practice indicated less reported missed nursing care, while a higher educational level meant more reported missed nursing care.Linking evidence to actionMost missed nursing care was reported within the subscales Planning and Basic Care. Thus, nursing activities are deprioritized in comparison to medical activities. Nurses holding a higher education reported more missed nursing care, indicating that higher education entails deeper knowledge of the consequences when rationing nursing care. They also reported varied use of evidence‐based practice, showing that higher education is not the only factor that matters. To decrease missed nursing care in clinical practice, and thereby increase the quality of care, educational level, use of evidence‐based practice, and organizational factors must be considered.