Prevalence and reasons for the occurrence of missed nursing care in medical and surgical departments: A cross-sectional study

Francesco Gravante; Yari Longobucco; Chiara Leone; Andrea Lombardi; Stefano Bambi

doi:10.18502/npt.v12i2.18338

Francesco Gravante Department of Emergency, Local Health Authority of Caserta, Caserta, Italy
Yari Longobucco Department of Health Sciences, University of Florence, Florence, Italy
Chiara Leone La Madonnina Nursing Home, Milan, Italy
Andrea Lombardi Department of Health, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy
Stefano Bambi Department of Health, University Hospital “San Giovanni di Dio e Ruggi d’Aragona”, Salerno, Italy

DOI: https://doi.org/10.18502/npt.v12i2.18338

Keywords: nurses; missed nursing care; management; patient safety; quality of care

Abstract

Background & Aim: Missed care is a serious problem in healthcare. This study aimed to measure the prevalence of missed nursing care and determine the reasons and risk factors for its occurrence in surgical and medical departments.

Methods & Materials: A cross-sectional design was used. All registered nurses who had worked for more than six months were included. The MISSEDCARE survey tool was used to determine missed nursing care (Part A) and the reasons for its occurrence (Part B). Logistic regression was used to determine risk factors for missed nursing care. The significance level was set at p<0.05.

Results: A total of 165 nurses were included. The response rate was 81.2%. The prevalence of missing nursing care ranged from 4.8% to 84.8%. Nurses with a high turnover intention had a great risk of the following missed nursing care: ‘medications administered within 30 min before or after the scheduled time’ [OR=11.60, CI 95%: 3.76-35.75; p<0.0001], ‘assess the effectiveness of medications’ [OR=3.79, CI 95%: 1.79-8.04; p<0.0001]. Urgent patient situations were the main reasons for missing patient-specific reassessment to verify improvement or deterioration during the shift [OR=6.82, CI 95%:1.84-25.26; p =0.008] and assess the effectiveness of medications.

Conclusions: This study showed a high prevalence of missed nursing care in surgical and medical departments. Urgent patient situations and unexpected increases in patient volume and acuity in the unit increased the reasons for missed nursing care. Nursing managers can promote the adoption of care models such as Primary nursing to reduce and manage missed nursing care