Prevalence rate of primary osteoporosis in China: a meta-analysis.

BACKGROUND: Primary osteoporosis (POP) is recognized as a "silent disease" and often ignored. This meta-analysis aimed to determine the prevalence of POP in the Chinese population over the past 20 years to raise awareness of the disease's epidemiology, which is hoped to help prevent and treat the condition better. METHODS: Eight English and three Chinese language databases were searched systematically from January 2002 to December 2023. Relevant data were analysed using Stata 16.0. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. A funnel plot was further drawn in combination with Egger and Begg tests to determine publication bias. RESULTS: A total of 45 studies (241,813 participants) were included. The meta-analysis revealed that the overall prevalence of POP in the Chinese population was 18.2% (95% CI: 14.7-21.7%), showing a positive correlation with age. Specifically, prevalence rates were 23.4% (18.3-28.5%) in women and 11.5% (9.1-13.9%) in men. A notable increase was observed within the span of 20 years (16.9% before 2010 and 20.3% in 2011-2020). Notably, regional variations were observed, with southern China reporting a lower prevalence of 16.4% compared to 20.2% in northern China. Meta-regression suggested that sample size significantly influenced the estimation of point prevalence (P = 0.037). CONCLUSIONS: Over the past two decades, there has been an increase in the prevalence of POP within the Chinese population. The growing prevalence of older individuals and women further highlights the urgency for tailored disease prevention and control measures.

Spousal Involvement in Collaborative Management and Glycemic Behavior Change among Patients with Diabetes Mellitus: A Systematic Review.

Introduction: The marked increase in the number of individuals with diabetes mellitus (DM) worldwide each year has resulted in the importance of the spouse's contribution to the promotion and support of patient self-management programs. Objectives: This study aimed to systematically explore the role or involvement of spouses in collaborative management and glycemic behavior change in DM. Methods: Five databases including Scopus, PubMed, Cumulative Index of Nursing and Allied Health Literature, SAGE, and Web of Science were reviewed for relevant articles retrieved from 2017 to 2022. Literature search used keywords, including "Spouse," "Support," "Self-management," "Glycemic Control," and "Diabetes mellitus." The Joanna Briggs Institute guidelines were used for appraisal review of journals. The component of partner support in the self-management of patients with DM is associated with an increase in the patient's glycemic level. Results: Twenty-five studies were identified that describe the different spousal roles and strategies in the promotion and support of DM management. Overall, spouses' involvement positively impacted healthy diets, higher self-efficacy, improved quality of psychological well-being, increased perceived support, and changes in glycemic-influenced behavior. Adaptation in the spouse patient relationship including maintaining cohesiveness can result in positive coping is essential in normalizing and contextualizing the chronic condition of DM. Partner-based collaboration is important for diabetes management, overcoming management barriers, and generating communal coping. Conclusion: This systematic review observed that the involvement of a spouse is important in improving collaborative management and results in better glycemic behavior in patients with DM. A better understanding of the relationship between spousal involvement, coping strategies, and adherence in daily management and the subsequent use of this information are highly useful for creating targeted and effective interventions.

Perceptions Toward Exercise or Mindful Exercise Participation Among Patients With Primary Osteoporosis: A Qualitative Study.

Exercise is significantly beneficial for patients with osteoporosis. However, physiological and psychological factors such as pain and kinesiophobia prevent patients from participating in exercise. Therefore, it is important to understand how these patients perceive participation in exercise. This qualitative study was conducted in China using conventional content analysis. Using a purposeful sampling method, 17 patients with primary osteoporosis were recruited. Data were collected through a semi-structured interview and managed using ATLAS.ti 21. Nine generic categories were developed from 26 subcategories and two main categories were identified: Barriers and facilitators, support systems, network resources, positive emotions, and reactions were the facilitators for exercise in this study. In addition, mindful exercise was positively viewed by the patients. Inefficient awareness, weak support systems, and burdens were identified as barriers. To improve compliance in clinical practice, targeted exercise protocols should be developed for patients based on these perceptions.

Effect of Video-Assisted Isometric Strengthening Exercise Program on Pain and Muscle Strength Poststabilization of Lower Limb Fracture.

The benefits of isometric strengthening exercises (ISEs) are compromised when patient teaching on ISEs is delayed and/or ineffectively delivered due to healthcare resources constraint, especially when health resources are stretched, as occurred during the COVID-19 pandemic. This study aims to examine the effect of a video-assisted ISE program on pain and muscle strength of patients following surgical stabilization of lower limb fracture. A quasi-experimental study with repeated measures was employed. Primary study outcomes were assessed using the Brief Pain Inventory and Manual Muscle Test. Effects over time were analyzed using generalized estimating equations. In comparison with usual care group (n = 32), the intervention group (n = 33) showed better pain reduction over time (p < .001, effect size [ES] = 0.39-1.77) and muscle strength preservation (p < .05; ES = 0.8-0.9). Patient acceptance of the intervention was favorable. Integration of video clips into patient teaching on ISEs is potentially beneficial in managing pain and muscle strength; it can be easily deployed to aid early ISE initiation.

Burnout, resilience, and empowerment among COVID-19 survivor nurses in Indonesia.

The primary frontline healthcare providers who have frequent contact with COVID-19 patients are nurses. Many nurses have been infected with COVID-19 and have experienced severe emotional exhaustion and burnout. It is essential to assess nurses' psychological health during the COVID-19 pandemic. This study aimed to analyze the factors associated with burnout, resilience, and empowerment among Indonesian COVID-19 nurse survivors. In this cross-sectional study, 182 COVID-19 survivor nurses participated from September to November 2022 with convenience sampling. An online survey using the Copenhagen Burnout Inventory (CBI), the Connor-Davidson Resilience Scale (CD-RISC), and the Psychological Empowerment Scale (PES) were used to collect data. The data were analyzed using descriptive and binary logistic regression analyses. The majority of the nurses were aged between 30-45 years (61.6%), and females (67.4%) experienced burnout. Higher resilience was found among nurses contracting COVID-19 (83.1%). In the multivariate logistic regression analysis, the absence of psychological impact (OR = 0.44, 95% CI = 0.21-0.93) is significantly related to higher burnout experience. In addition, workplace, especially in hospital (OR = 4.32, 95% CI = 1.09-17.09) was associated with resilience, and a gap time after receiving negative COVID-19 result (OR = 3.90, 95% CI = 1.27-12.03) was correlated with psychological empowerment, in our results 4-6 month after had a negative result was at higher risk. To maintain a positive psychological aspect for COVID-19 nurse survivors, it needs to implement psychological support in the workplace and ensure an appropriate workload of nurse professionals.

Family caregivers' perspective of caring for cancer patients during radiotherapy: A qualitative study.

Objectives: To explore the perspective of family caregivers of cancer patients undergoing radiotherapy. Method: The descriptive, qualitative study was conducted at the Indonesia Cancer Foundation, Surabaya, Indonesia, in July and August 2019, and comprised family caregivers of cancer patients undergoing radiotherapy. Data was collected using in-depth semi-structured interviews which were recorded, transcribed and analysed using conventional content analysis. RESULTS: Of the 26 caregivers aged 24-65 years, 16(62%) were men, 19(73%) were married, and 14(56%) had close relationships with the patients. Among the patients, 4(15.4%) had breast cancer, 2(7.6%) had nasopharyngeal cancer and 20(77%) had cervical cancer. The themes identified were uncertainty, disintegration and burden. CONCLUSIONS: Caregivers of cancer patients tended to have both physical and emotional challenges.

Analysis of factors that affect the utilization of antenatal care in developing countries: A systematic review.

Objectives: To explain the factors related to the implementation of antenatal care in developing countries. Method: The systematic review was conducted in June 2020 and comprised literature search on Scopus, Cumulated Index to Nursing and Allied Health Literature, PubMed and Garba Rujukan Digital databases for cross-sectional, survey-based, prospective, mixed-method, correlational, experimental, longitudinal, cohort and case-control studies published after 2015 in either English or Indonesian. The studies included involved pregnant women and discussed the factors of implementing antenatal care in developing countries, and explained the factors related to the implementation of antenatal care in accordance with the World Health Organisation recommendation. The Population, Intervention, Comparison, Outcomes and Study framework was used, and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed. Data was analysed using descriptive statistics with a narrative approach. RESULTS: Of the 9,733 studies initially found, 50(0.005%) were shortlisted for full-text review, and, of them, 15(30%) were reviewed and analysed. There were 3(20%) each from Pakistan and Ghana, 2(13.3%) each from Nepal and India, and 1(6.66%) each from Jordan, Egypt, Yemen, South Africa and Vietnam. Overall, 10(66.6%) were cross-sectional studies. There were five factors identified regarding antenatal care; behaviour intention, social support, accessibility of information, personal autonomy, and action situations, including economic status, availability of facility and transportation. CONCLUSIONS: Antenatal care in pregnant women in developing countries is influenced by several factors, and economic status and the availability of facilities and infrastructure optimise the use of such services.

The Mediating Role of Work Satisfaction in the Relationship between Organizational Communication Satisfaction and Organizational Commitment of Healthcare Professionals: A Cross-Sectional Study.

The factors that influence the organizational commitment of healthcare professionals, particularly organizational communication and work satisfaction, are essential for all healthcare organizations. This is particularly important for those who are under the pressure of high demand, economic constraints, and staff shortages. This study examined the relationship between organizational communication satisfaction and organizational commitment among healthcare professionals and the mediating role of work satisfaction in the relationship. A validated self-administered questionnaire and a universal sampling approach were used to conduct a cross-sectional survey of 235 healthcare professionals in the Gaza Strip, Palestine. The data were analyzed using SPSS version 25 and SmartPLS software to perform partial least squares structural equation modeling (PLS-SEM). A STROBE checklist was used to report the results. The results show a significant positive correlation between all measured variables. Work satisfaction partially mediates the relationship between organizational communication satisfaction and organizational commitment. The results of the PLS-SEM analyses suggest that communication satisfaction and work satisfaction account for 61% of the variation in organizational commitment. This study reveals that work satisfaction and communication satisfaction are imperative to building a sense of commitment in healthcare professionals. These results reinforce the existing evidence on the factors that influence the organizational commitment of healthcare professionals. Strategies to better shape internal communication practices and improve the work environment through regular feedback to healthcare professionals are essential to strengthening their organizational commitment.

Succession Planning Leadership Model for Nurse Managers in Hospitals: A Narrative Review.

The high number of nursing staff in Indonesia requires optimal management skills, one of which comes from the leadership domain. The succession planning program can be an option to prepare nurses who have leadership potential to carry out a management function. This study aims to identify the nurse succession planning model and its application in clinical practice. This study uses a narrative review of the literature approach. Article searches were carried out using electronic databases (PubMed and Science Direct). Researchers obtained 18 articles. Three main themes emerged: (1) the factors that influence the efficient implementation of succession planning, (2) the benefits of succession planning, and (3) the implementation of succession planning in clinical practice. Training and mentoring related to leadership, support from human resources, and adequate funding are the main factors in implementing effective succession planning. Succession planning also can help nurses find competent leaders. However, in its application in clinical practice, the process of recruitment and planning for nurse managers that occurs in the field is not optimal so that succession planning must exist and be integrated with organizational needs and provide guidance and assistance for the younger generation who will become leaders in the future.

Nurses' Perception and Satisfaction Toward Electronic Medical Record System.

AIM: This study aims to assess the perception and satisfaction of nurses toward the electronic medical record system in a teaching hospital. METHOD: A cross-sectional study was conducted among 350 nurses in a teaching hospital via a self-administered questionnaire between May to October 2019. Descriptive analysis, independent t-test, analysis of variance, and hierarchical multiple regression were used to analyze the data using Statistical Package for Social Sciences software version 25. In addition, a The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used as guide in reporting the results of this study. RESULTS: Almost all the nurses (98%, n = 343) had a positive perception toward the electronic medical record system, though their perceptions significantly differ across work units, computer or laptop ownership, and daily time spent on the system (all p < .05). Nurses who had received training reported better satisfaction with the system. CONCLUSION: Among the issues highlighted by the participants that warrant attention were system development and connectivity. This study, therefore, emphasizes the involvement of nursing personnel in system development to ensure an appropriate approach for nursing care delivery.

An Evaluation of Improving Psychosocial Life Satisfaction among Older Adults in Taiwan Day Care Centers Using Life Review Work.

This study examined the effects of life review therapy on the life satisfaction levels of older adults in day care centers in Taiwan. A quasi-experimental design was adopted. A total of 88 adults aged 65 and older were recruited from day care centers through convenience sampling and assigned to two groups based on their level of life satisfaction on Life Satisfaction Index A. The intervention groups participated in a life review therapy for eight weeks in addition to their daily activities. Data were collected at the baseline point and immediately after post-intervention. Generalized estimating equations were used to examine the effect of the intervention on the outcomes. At week eight, the intervention group showed a significantly higher level of life satisfaction than the comparison group. These findings suggest that life review programs may improve general life satisfaction among older adults.

Career maturity, psychological resilience, and professional self-concept of nursing students in China: A nationwide cross-sectional study.

BACKGROUND: The career maturity of nursing students has an influence on their individual career choices and their personal career development trajectory. Psychological resilience and a positive professional self-concept might help students adjust and adapt to their nursing careers. Therefore, there is a growing need to assess and develop these psychological concepts among nursing students. PURPOSE: This study aimed to determine the levels of career maturity, psychological resilience, and professional self-concept among Chinese senior nursing students as well as to examine the relationships between the variables. METHODS: A cross-sectional survey was carried out across six undergraduate medical colleges in China from May to August 2021. A total of 1223 full-time final year undergraduate nursing students who fulfilled the study criteria were recruited using the universal sampling method. Self-administered questionnaires including the Career Maturity Scale (CMS), Connor-Davidson Resilience Scale-2 (CD-RISC2), and Professional Self-Concept of Nurses Instrument (PSCNI) were used for data collection. For results reporting, the study complied with the STROBE checklist. RESULTS: The participants' career maturity, professional self-concept, and psychological resilience were found to be at moderate levels. Experience of being a class leader and actively choosing a nursing major were factors that had significant influence on students' career maturity, professional self-concept, and psychological resilience. Pearson's correlation analysis revealed career maturity to be closely related to professional self-concept and psychological resilience (p < 0.01). Results of structural equation modelling analyses revealed a good fit to the data based on various fit indices (χ2/df = 6.18, GFI = 0.926, CFI = 0.915, IFI = 0.957, RMSEA = 0.058). Nursing students with positive professional self-concepts demonstrated higher psychological resilience, which in turn influenced their career maturity. CONCLUSIONS: The results of this study provide the initial indications for an extended career maturity model. A positive professional self-concept and psychological resilience has the potential to improve the career maturity of nursing students. The study findings provide a basis for nursing educators to focus on improving the professional self-concept and psychological resilience of nursing students.

Effects of Self-Care Education Intervention Program (SCEIP) on Activation Level, Psychological Distress, and Treatment-Related Information.

Self-care education can direct patients to manage their side effects during treatment, reduce psychological distress, and improve self-care information. In this study, the effectiveness of the Self-Care Education Intervention Program (SCEIP) on patient activation levels, psychological distress, and treatment-related concerns in women with breast cancer was assessed by adopting a longitudinal quasi-experimental pre-test and post-test design. The data for 246 women with breast cancer undergoing adjuvant chemotherapy were collected. Pre- and post-interventional assessments were conducted at baseline (T1) and the second (T2), fourth (T3), and sixth (T4) cycles using the 13-item Patient Activation Measure, 14-item Hospital Anxiety and Depression Scale, and 25-item Cancer Treatment Survey. It was found that the SCEIP significantly improved the activation level (p ≤ 0.001), psychological distress (anxiety level (p ≤ 0.001), the depression level (p ≤ 0.001)), and treatment-related concerns (sensory/psychological concerns (p = 0.05); procedural concerns (p ≤ 0.001)). Therefore, the SCEIP could potentially improve patients' activation level, psychological distress, and treatment-related concerns regarding symptom management during chemotherapy, specifically for Malaysian women with breast cancer.

The Food Safety Knowledge, Attitude and Practice of Malaysian Food Truck Vendors during the COVID-19 Pandemic.

Foodborne diseases are one of the greatest public health threats, but they can be prevented by maintaining food safety practices. Although the food safety literature has been awash with studies from various food operations, there is very limited information on food safety in the food truck business. Therefore, this study aims to assess the level of knowledge, attitude, and practices related to food safety among food truck vendors. A cross-sectional study was conducted among 396 Malaysian food truck vendors using convenience sampling. Data was collected during the Recovery Movement Control Order due to the COVID-19 pandemic through a validated self-administered questionnaire and analyzed using SPSS version 25. The findings indicated that food truck vendors generally have fair knowledge (M = 78.8, SD = 9.09), a positive attitude (M = 94.8, SD = 5.95), and good practices (M = 84.7, SD = 6.62) regarding food safety during the COVID-19 pandemic. Hierarchical regression analysis further showed that food truck vendors' level of education and knowledge of food safety are significant predictors of their food safety practices. This study provides an initial understanding of the food safety knowledge, attitude, and practices among food truck vendors and yields important information in promoting the food safety culture.

The impact of organisational communication satisfaction on health care professionals' work engagement.

AIM: To assess the impact of organisational communication satisfaction (OCS) on the work engagement of health care professionals (HCPs). BACKGROUND: Organisational communication can influence employees' work engagement, which is an essential component of an organisation's effectiveness. However, these concepts have not been broadly investigated in health care organisations. METHODS: A cross-sectional survey was administered to 235 HCPs in the Gaza Strip, Palestine. The SPSS statistical software (version 25) and partial least squares structural equation modelling (PLS-SEM) were used to analyse the collected data. RESULTS: The HCPs reported a moderate level of OCS (M = 4.96, SD = 0.94) and work engagement (M = 5.56, SD = 0.96). The impact of OCS on work engagement was found to be positive and statistically significant (ß = .524, p < .05). No significant difference was revealed in level of OCS or work engagement among the HCPs according to their job categories. Only years of experience significantly influenced their OCS. CONCLUSION: Improving HCPs' satisfaction with organisational communication is vital in enhancing their work engagement and, ultimately, sustaining health care manpower. IMPLICATIONS FOR NURSING MANAGEMENT: Strategies for improving the quantity and quality of organisational communication must be prioritized to strengthen work engagement among HCPs. These strategies include management's role in and ways of communicating essential information about their organisations to HCPs.

Knowledge, attitude and practice in relation to catheter-associated urinary tract infection (CAUTI) prevention: A cross-sectional study.

BACKGROUND: Healthcare-associated infection (HAI) is one of the major threats to patients' safety besides being among the principal causes of patient morbidity and mortality. Catheter-associated urinary tract infection (CAUTI) is reported to be the most common HAI worldwide. CAUTI can be prevented with appropriate practice and care by healthcare personnel, especially nurses, who play the main role in urinary catheter care. Nurses' knowledge and attitude are considered to be important factors that influence their practice. OBJECTIVES: To assess nurses' level of knowledge, attitude and perceived practice regarding CAUTI and its preventive measures. METHODS: A cross-sectional design was adopted, and a self-administered questionnaire was used to collect data. Nurses from the medical and surgical inpatient wards of a tertiary teaching hospital in Malaysia were recruited in two stages using the stratified and simple random sampling methods. A total of 301 nurses participated. Descriptive analysis, an independent t test, ANOVA and hierarchical multiple regression were employed to analyse the data using SPSS software version 25. In addition, a STROBE checklist was used to report the results of this study. RESULTS: Nurses were found to have good knowledge, a positive attitude and good perceived practice regarding CAUTI prevention. Nurses aged above 30 and who had more than ten years of experience reported higher knowledge levels. Knowledge was found to be positively correlated with attitude and perceived practice; however, attitude explained a higher variance in perceived practice of CAUTI prevention compared with knowledge. CONCLUSION: Attitude was found to have a higher significant influence on perceived practice in this study. Educators need to emphasise the inculcation of a positive attitude among nurses rather than just knowledge for CAUTI prevention. Since this study assessed perceived practice, examining nurses' actual practice and its impact on patient outcomes is recommended in future studies.

Challenges for Healthcare Workers Caring for COVID-19 Patients in Indonesia: A Qualitative Study.

COVID-19 pandemic raises various challenges faced by health workers in hospitals. This study explored strategies for overcoming challenges in caring for COVID-19 patients at hospitals in Indonesia based on healthcare workers' experience. In-depth interviews were employed with 28 healthcare workers (physicians and nurses) who were purposively sampled. Data were collected via phone and analysed using the Colaizzi method. Five following challenges were found: difficulties in working with personal protective equipment (PPE), offline training for handling Covid and using PPE not being implemented evenly for all health workers, physical and psychological fatigue, difficulties in carrying out health education and assessment towards patients and families, and limited resources to cope with the COVID-19 pandemic. Meanwhile, some barriers require support from the government, public and hospital managers. The information gained from research on the strategies for caring for COVID-19 patients can contribute to better preparedness for hospitals and health workers facing the COVID-19 pandemic.

The COVID-19 Global Pandemic and Its Impact on the Mental Health of Nurses in Malaysia.

The Coronavirus disease 2019 (COVID-19) global pandemic since its onset has had a dramatic and often devastating impact, both physical and psychological, on all healthcare workers. This study aimed to assess the impact of psychological distress that COVID-19 has on nurses, as well as the coping strategies that they employed. This is a cross-sectional national online survey. A total of 859 nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia participated in the study. More than three-quarters of the nurses experienced stress (77.2%). A total of 88.7% and 7.2% of nurses revealed a moderate and high stress level, respectively. Approximately one in eight (12.1%) nurses reported feeling depressed. Nurses working in the outpatient departments reported significantly higher stress levels than nurses working in inpatient care departments. Nurses having chronic health problems reported significantly higher depression levels than nurses with no chronic health problem. Highly stressed or depressed nurses tend to adopt avoidance coping strategies while religion and emotional support were used regardless of the stress or depression levels experienced. The findings of the study provide insight into the mental health and coping strategies of nurses actively involved in caring for patients with suspected or confirmed COVID-19 in Malaysia. This would be of tremendous help to nursing administrators in implementing mental health services for nurses during and following the COVID-19 global pandemic.

Escalating progression of mental health disorders during the COVID-19 pandemic: Evidence from a nationwide survey.

Since the first nationwide movement control order was implemented on 18 March 2020 in Malaysia to contain the coronavirus disease 2019 (COVID-19) outbreak, to what extent the uncertainty and continuous containment measures have imposed psychological burdens on the population is unknown. This study aimed to measure the level of mental health of the Malaysian public approximately 2 months after the pandemic's onset. Between 12 May and 5 September 2020, an anonymous online survey was conducted. The target group included all members of the Malaysian population aged 18 years and above. The Depression Anxiety Stress Scale (DASS-21) was used to assess mental health. There were increased depressive, anxiety and stress symptoms throughout the study period, with the depression rates showing the greatest increase. During the end of the data collection period (4 August-5 September 2020), there were high percentages of reported depressive (59.2%) and anxiety (55.1%) symptoms compared with stress (30.6%) symptoms. Perceived health status was the strongest significant predictor for depressive and anxiety symptoms. Individuals with a poorer health perception had higher odds of developing depression (odds ratio [OR] = 5.68; 95% confidence interval [CI] 3.81-8.47) and anxiety (OR = 3.50; 95%CI 2.37-5.17) compared with those with a higher health perception. By demographics, young people-particularly students, females and people with poor financial conditions-were more vulnerable to mental health symptoms. These findings provide an urgent call for increased attention to detect and provide intervention strategies to combat the increasing rate of mental health problems in the ongoing COVID-19 pandemic.

Missed nursing care in the Malaysian context: A cross-sectional study from nurses' perspective.

AIM: To determine the occurrence, factors and outcome of missed nursing care from the perspective of Malaysian nurses. BACKGROUND: Missed nursing care is an important issue in the global health care sector. However, little is known on the extent of missed nursing care in the Malaysian context and its contributing factors. METHODS: A cross-sectional design was adopted for data collection using the MISSCARE Survey instrument. Participants comprised 364 nurses from medical and surgical wards of a large teaching hospital. Data were analysed using descriptive, binomial logistic and hierarchical regression analyses. RESULTS: The overall occurrence of missed nursing care was 1.88 (on a scale of 1.00-5.00), which differed across 24 nursing care elements. Basic nursing care and communication-related care were the most frequently missed elements. Types of ward and labour resources were identified as contributing factors to missed nursing care (p < .001). No significant association was found between missed nursing care and nurses' intention to leave (p > .05). CONCLUSION: The occurrence of missed nursing care was noted to be low. IMPLICATIONS FOR NURSING MANAGEMENT: Practical strategies such as an acuity-based staffing system, close monitoring of rendered care and strengthening of teamwork are recommended to minimize missed nursing care.