Missed or rationed nursing care: Where to now for the nurse manager?

Kirwan, Marcia; Schubert, Maria

doi:10.1111/jonm.13078

Cited by 8 publications

(7 citation statements)

References 25 publications

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“…MNC is a unit outcome which was influenced by the facility level domain of NWE in our study. This domain is a known modifiable factor (Kirwan & Schubert, 2020 ) and its refinement could be a cornerstone for interventions to reduce the prevalence of MNC. However, the other studied dimensions of the NWE were not, as proposed, significantly associated with MNC.…”

Section: Discussionmentioning

confidence: 99%

“…The COVID‐19 pandemic has predominantly underlined what nurses “do” rather than what they “cannot do” (Kirwan & Schubert, 2020 ) and has positively changed the public perception of nurses in many countries. However, during this critical period, nurses are facing challenges of concerns for workplace safety (feelings of fear and threat of infection, concerns about the transmission of the infection to family members or about the consequences of COVID‐19, etc.…”

Section: Introductionmentioning

confidence: 99%

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Missed nursing care in hospital environments during the COVID‐19 pandemic

Gurková

Mikšová

Šáteková

2021

International Nursing Review

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Background Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID‐19 pandemic. Aims The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID‐19 pandemic. Methods A cross‐sectional study was used. The RANCARE guideline and STROBE checklist were followed for reporting in the study. The sample consisted of 371 nurses from four acute care hospitals. The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data. The data were analyzed using multiple linear and logistic regression analyses. Results Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care. Prevalence estimates of missed care in Czech acute care hospitals during the COVID‐19 pandemic was predicted from the overtime work, the nurses’ perception of the “Nursing foundations for the quality of care,” and their satisfaction with their current position. Conclusions Missed nursing care could be mitigated by improving the nurses’ work environment. Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care. Implications for nursing policy Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses’ concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Missed nursing care in hospital environments during the COVID‐19 pandemic

Gurková

Mikšová

Šáteková

2021

International Nursing Review

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“…Our findings support these empirical findings. However, given the importance given to relationships and communication factors in teams as a strategy to reduce MNC (Kirwan & Schubert, 2020), we could not help but wonder— why is it that their linear impact is so obviously missing in our data? When discussing these findings with our colleagues, it was pointed out that it is possible that our results may in fact reflect the current labor‐related difficulties experienced during the Covid‐19 pandemic (Romero‐Sánchez et al, 2022).…”

Section: Discussionmentioning

confidence: 90%

External influencing factors on missed care in Austrian hospitals: Testing the theoretical antecedents of missed care using structural equation modelling

Cartaxo

Dabney

Mayer

et al. 2023

Journal of Advanced Nursing

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ProblemMissed Nursing Care (MNC) is an error of omission which occurs when a necessary nursing intervention is not initiated, is not completed, or when it is delayed. The MNC model explains this problem and describes four antecedents that can lead to MNC: (1) demand for patient care, (2) available human resources, (3) material resources, and (4) and relationship and communication factors.AimsThis study aims to test the relationship between the theoretical antecedents of MNC and their impact on MNC.DesignA quantitative cross‐sectional study.MethodsThe Austrian version of the revised MISSCARE Survey was completed by nurses working in general hospital units between May and July 2021. Recruitment followed a respondent‐driven sample via Austrian nursing education institutions and social media. One thousand six nurses fulfilled inclusion criteria. The structure of the theoretical constructs of the MNC model was tested using a confirmatory factor analysis approach. The relationships between the four antecedents and MNC were explored using structural equation modelling with 427 complete cases.ResultsThe results support the structural validity of the revised MISSCARE Austria concerning the defined theoretical constructs, although discriminant validity and measurement error should be further investigated. The antecedent “resource allocation: labor” had a statistically significant impact on MNC: The lack of adequate nursing staff played the most important role to explain missed care in our model.ConclusionIn our study in Austria, MNC was mostly influenced by a lack of appropriate labor resources. Further studies exploring mediation effects and non‐linear relationships may contribute to better understanding of reasons for MNC.Patient or Public ContributionNo patient or public contribution.

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“…The NMs' perspective on MNC is particularly meaningful because they play a pivotal role in the provision of high-quality and safe care 5 and serve as role models for other nurses. They are often responsible for labor resources, skill mix, staff support, and leadership and advocacy on behalf of the nursing team.…”

Section: The Important Role Of Nmsmentioning

confidence: 99%

Examining the Perspectives of Nurse Managers on Missed Nursing Care in Surgical Units

Kohanová,

Kirwan,

Bartoníčková

et al. 2024

JONA: The Journal of Nursing Administration

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OBJECTIVE To examine nurse managers' perspectives on missed nursing care (MNC) on surgical units. BACKGROUND The phenomenon of MNC is an important concern for nurse researchers. However, the reality of how it is experienced by clinical nurse managers is largely unexplored. Understanding nurse managers' experiences with MNC could help develop useful approaches to reducing levels of MNC. METHODS A descriptive qualitative study was conducted between December and June 2020, using face-to-face semistructured interviews with 10 nurse managers. RESULTS Five themes were identified: 1) awareness of MNC; 2) rationale for MNC; 3) consequences of MNC; 4) questions of reporting; and 5) management of MNC. CONCLUSIONS Nurse managers must use their positions and leadership skills to expect appropriate staffing approaches and material resources for surgical units, effective process for newly hired nurses, and the establishment of a reporting system for MNC to reduce the phenomenon in practice.

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Missed or rationed nursing care: Where to now for the nurse manager?

Cited by 8 publications

References 25 publications

Missed nursing care in hospital environments during the COVID‐19 pandemic

Missed nursing care in hospital environments during the COVID‐19 pandemic

External influencing factors on missed care in Austrian hospitals: Testing the theoretical antecedents of missed care using structural equation modelling

Examining the Perspectives of Nurse Managers on Missed Nursing Care in Surgical Units

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