Print “PDF version”
What’s New in the
Patient Safety World
June 2024
More on Missed
Nursing Care
Missed nursing care is related to mismatches between patient care needs and nursing workload and has an impact on patient morbidity and mortality. Edfeldt et al. recently reported results of a study on missed nursing care related to surgical patients (Edfeldt 2024). They used the Swedish version of the MISSCARE survey (Nymark 2020) to measure missed nursing care and associated reasons on three surgical wards in Swedish hospitals. Both registered nurses and nursing assistants participated and the response rate was very good (88%).
There was often disparity between responses of the RN’s compared to the nursing assistants and RN’s tended to cite more missed care. Aspects of nursing care that were rated to be missed the most often were:
· attending interdisciplinary care conferences
· turning patient every 2 h
· ambulation 3 times per day or as ordered
But the aspects of missed care really ran the gamut of nursing care.
The most frequent reasons for missed nursing care were:
· inadequate number of staff
· unexpected rise in patient volume and/or acuity on the unit
· urgent patient situations
Almost a quarter of staff members indicated an intention to leave their present department within a year. Though more RN’s (67.2%) were satisfied or very satisfied with their current position than nursing assistants (19%), there was no difference in intention to leave. The authors note that a high patient-nurse ratio increases burnout, ethical stress and job dissatisfaction, which in turn leads to an increase in the intention to leave the workplace.
They also noted, however, that improvements with communications issues were needed, with 18.9% of staff not satisfied (or neutral) with teamwork.
The authors also suggest that RN shortages cannot be solved simply with an increased number of less-trained nursing staff.
Some of our other columns on nursing workload and missed
nursing care/care left undone:
November 26, 2013 “Missed Care: New Opportunities?”
May 9, 2017 “Missed Nursing Care and Mortality Risk”
March 6, 2018 “Nurse
Workload and Mortality”
May 29, 2018 “More
on Nursing Workload and Patient Safety”
October 2018 “Nurse
Staffing Legislative Efforts”
February 2019 “Nurse
Staffing, Workload, Missed Care, Mortality”
July 2019 “HAI’s and Nurse Staffing”
September 1, 2020 “NY State and Nurse Staffing Issues”
February 9, 2021 “Nursing Burnout”
August 2021 “The New NY State Law on Nursing Staffing”
January 2022 “Another Striking Nurse Staffing Study”
References:
Edfeldt K, Nyholm L, Jangland E, et al. Missed nursing care in surgical care– a hazard to patient safety: a quantitative study within the inCHARGE programme. BMC Nurs 2024; 23: Article 233
https://bmcnurs.biomedcentral.com/articles/10.1186/s12912-024-01877-1#citeas
Nymark C, Göransson KE, Saboonchi F, et al. Translation, culture adaption and psychometric testing of the MISSCARE Survey—Swedish version. J Clin Nurs 2020; 29(23–24):4645-4652
https://onlinelibrary.wiley.com/doi/10.1111/jocn.15505
Print “PDF version”
http://www.patientsafetysolutions.com/
What’s New in
the Patient Safety World Archive