Unfinished nursing care: An important performance measure for nursing care systems

VanFosson, Christopher A; Jones, Terry; Yoder, Linda H.

doi:10.1016/j.outlook.2015.12.010

Cited by 54 publications

(47 citation statements)

References 72 publications

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“…Also the focus group participants stated consequences related to health professionals. Apart from nurses' own safety (a higher probability of work accidents), they mentioned increasing frustration, feelings of personal failure and inferiority, consistently with numerous other studies [20,24,25].…”

Section: Consequences Of Missed Caresupporting

confidence: 80%

Rationed nursing care – conclusions from focus groups

Janíková

Plevová

Jarošová

2019

Pielegniarstwo XXI Wieku / Nursing in the 21st Century

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Phone: +420 604 312 622 STRESzCzENIE RACJONOwANA OPIEkA PIElęGNIARSkA -wNIOSkI z GRUP fOkUSOwyCH Cel. Zbadanie za pomocą grup fokusowych głównych obszarów niedopełnienia opieki oraz zidentyfikowanie jak postrzegane są przyczyny, skutki i propozycje potencjalnych rozwiązań. Metody. W początkowym etapie badania wybrano metodę doboru grupy fokusowej. Utworzono trzy grupy fokusowe zlożone z 25 pielęgniarek pracujących na oddziałach stacjonarnych placówek opieki zdrowotnej regionu Morawsko-Śląskiego. wyniki. Na podstawie analizy treści, wyodrębniono cztery kategorie: przyczyny i skutki niedopełnienia opieki, niedopełnienia w podejmowaniu interwencji oraz sugestie potencjalnych rozwiązań. Kategorie te zostały następnie podzielone na podkategorie. Przyczyny niedopełnienia opieki odnosiły się do osobowości pielęgniarki, osobowości pacjenta, systemu opieki zdrowotnej i systemu zarządzania. Niedopełnienia w podejmowaniu interwencji zostały podzielone na interwencje podstawowej opieki pielęgniarskiej, specjalistyczne interwencje podejmowane przez pielęgniarki oraz wspólne czynności. Skutki niedopełnienia opieki dotyczyły zarówno pacjentów jak i personelu. Sugestie potencjalnych rozwiązań zawierały zmiany w zarządzaniu i marketingu, jak również w edukacji pracowników służby zdrowia i w opiece nad pacjentem. wnioski. W odniesieniu do racjonowania opieki, jakość zapewnianej opieki zdrowotnej nie może narażać na ryzyko bezpieczeństwa personelu oraz pacjentów. Otwarta dyskusja na powyższe tematy może zaowocować znalezieniem innych potencjalnych rozwiązań które mogłyby być praktycznie wdrażane. Słowa kluczowe: grupa fokusowa, interwencja pielęgniarska, racjonowana opieka, pielęgniarstwo, pielęgniarka ogólna AbSTRACT RATIONED NURSING CARE -CONClUSIONS fROM fOCUS GROUPS Aim. The focus groups aimed to outline the main areas of missed care and identify how the causes, effects and potential solution proposals are perceived. Methods. For the initial part of the research, the focus group method was selected. Three focus groups were organized which comprised 25 nurses working in inpatient wards of healthcare facilities in the Moravian-Silesian Region. Results. Based on the content analysis, four main categories were established: causes and consequences of missed care, missed interventions and suggestions for potential solutions. These were further divided into subcategories. The causes of missed care were related to the nurse's personality, patient's personality, healthcare system and management system. Missed interventions were classified into basic nursing care interventions, specialized interventions to be performed by nurses and common activities. The consequences of missed care affect both patients and the staff. The suggestions for potential solution included changes in management and marketing, education of healthcare professionals and patient care.Conclusions. With respect to care rationing, the quality of care provided must not be compromised to a point where the safety of the staff and patients is at risk. Discussing these issu...

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Section: Consequences Of Missed Caresupporting

confidence: 80%

Rationed nursing care – conclusions from focus groups

Janíková

Plevová

Jarošová

2019

Pielegniarstwo XXI Wieku / Nursing in the 21st Century

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“…In the face of excessive workloads, nurses may be unable to complete all necessary care activities and must, in effect, engage in what is described as “implicit rationing” (Schubert, Glass, Clarke, Schaffert‐Witvliet, & De Geest, ). Missed nursing care has also been suggested as a potential quality measure linked to the adequacy of nursing staffing (National Institute for Clinical Excellence, ; VanFosson et al., ), acting as a leading indicator which could more sensitively indicate problems arising from low staffing before they could be detected through adverse outcomes (Ball, Murrells, Rafferty, Morrow, & Griffiths, ).…”

Section: Introductionmentioning

confidence: 99%

“…Missed nursing care has also been suggested as a potential quality measure linked to the adequacy of nursing staffing (National Institute for Clinical Excellence, 2012;VanFosson et al, 2016), acting as a leading indicator which could more sensitively indicate problems arising from low staffing before they could be detected through adverse outcomes (Ball, Murrells, Rafferty, Morrow, & Griffiths, 2014).…”

Section: Introductionmentioning

confidence: 99%

The association between nurse staffing and omissions in nursing care: A systematic review

Griffiths

Recio‐Saucedo

Dall’Ora

et al. 2018

Journal of Advanced Nursing

393

416

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AimsTo identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing.BackgroundResearch has established associations between nurse staffing levels and adverse patient outcomes including in‐hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy.DesignSystematic review.Data SourcesWe searched the Cochrane Library, CINAHL, Embase and Medline for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles.Review MethodsTwo reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative.ResultsEighteen studies gave subjective reports of missed care. Seventy‐five per cent or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care.ConclusionsLow Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures, is yet to be investigated.

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“…More than a simple list of indicators, the NCPF provides an integrative and systemic framework that has been used in recent studies to analyze various dimensions of nursing care [23,24]. The NCPF has been used, for example, to structure a scoping review undertaken to identify indicators that are sensitive to ambulatory nursing [23].…”

Section: Introductionmentioning

confidence: 99%

Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews

et al. 2017

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BackgroundInformation and communication technologies (ICTs) are becoming an impetus for quality health care delivery by nurses. The use of ICTs by nurses can impact their practice, modifying the ways in which they plan, provide, document, and review clinical care.ObjectiveAn overview of systematic reviews was conducted to develop a broad picture of the dimensions and indicators of nursing care that have the potential to be influenced by the use of ICTs.MethodsQuantitative, mixed-method, and qualitative reviews that aimed to evaluate the influence of four eHealth domains (eg, management, computerized decision support systems [CDSSs], communication, and information systems) on nursing care were included. We used the nursing care performance framework (NCPF) as an extraction grid and analytical tool. This model illustrates how the interplay between nursing resources and the nursing services can produce changes in patient conditions. The primary outcomes included nurses’ practice environment, nursing processes, professional satisfaction, and nursing-sensitive outcomes. The secondary outcomes included satisfaction or dissatisfaction with ICTs according to nurses’ and patients’ perspectives. Reviews published in English, French, or Spanish from January 1, 1995 to January 15, 2015, were considered.ResultsA total of 5515 titles or abstracts were assessed for eligibility and full-text papers of 72 articles were retrieved for detailed evaluation. It was found that 22 reviews published between 2002 and 2015 met the eligibility criteria. Many nursing care themes (ie, indicators) were influenced by the use of ICTs, including time management; time spent on patient care; documentation time; information quality and access; quality of documentation; knowledge updating and utilization; nurse autonomy; intra and interprofessional collaboration; nurses’ competencies and skills; nurse-patient relationship; assessment, care planning, and evaluation; teaching of patients and families; communication and care coordination; perspectives of the quality of care provided; nurses and patients satisfaction or dissatisfaction with ICTs; patient comfort and quality of life related to care; empowerment; and functional status.ConclusionsThe findings led to the identification of 19 indicators related to nursing care that are impacted by the use of ICTs. To the best of our knowledge, this was the first attempt to apply NCPF in the ICTs’ context. This broad representation could be kept in mind when it will be the time to plan and to implement emerging ICTs in health care settings.Trial RegistrationPROSPERO International Prospective Register of Systematic Reviews: CRD42014014762; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42014014762 (Archived by WebCite at http://www.webcitation.org/6pIhMLBZh)

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Unfinished nursing care: An important performance measure for nursing care systems

Cited by 54 publications

References 72 publications

Rationed nursing care – conclusions from focus groups

Rationed nursing care – conclusions from focus groups

The association between nurse staffing and omissions in nursing care: A systematic review

Impact of Information and Communication Technologies on Nursing Care: Results of an Overview of Systematic Reviews

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