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1.
J Nurs Scholarsh ; 2024 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-39160684

RESUMO

INTRODUCTION: While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care. METHODS: This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale. RESULTS: A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (ß = 2.492, p < 0.001) and a lower frequency of missed nursing care (ß = -0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (ß = -0.055, p < 0.001). CONCLUSION: Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care. CLINICAL RELEVANCE: Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.

2.
J Adv Nurs ; 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39315744

RESUMO

AIM: To examine the association between nurses' insomnia, presenteeism and care left undone and explore the mediating effect of presenteeism on the relationship between insomnia and care left undone among nurses in acute care hospitals, applying a dynamic model of presenteeism and absenteeism. DESIGN: A cross-sectional design. METHODS: A secondary data analysis was conducted using online survey data collected in January 2023. Participants were 1154 registered nurses who provided direct nursing care to patients in tertiary or general hospitals (hospitals with 300 or more beds) in South Korea. Poisson regression analysis was used to examine the association between nurses' insomnia, presenteeism and care left undone. Generalised structural equation modelling was performed to examine the mediating effect of presenteeism on the relationship between insomnia and care left undone. RESULTS: The prevalence of insomnia was 15.3%. More than half of the participants (63.7%) reported experiencing presenteeism in the past 4 weeks. All reported at least one nursing care left undone during their last shift. Insomnia and presenteeism were positively associated with care left undone, and presenteeism mediated the relationship between insomnia and care left undone among nurses in acute care hospitals. CONCLUSION: Nurses experienced insomnia and presenteeism, related to higher rates of care left undone. Nurses' insomnia had a direct effect on care left undone and an indirect effect through presenteeism. IMPLICATIONS FOR THE PROFESSION: Nurse managers and administrators need to make greater efforts to reduce insomnia and presenteeism among nurses, thereby reducing care left undone and improving patient safety in acute care settings. IMPACT: Nurse managers and administrators should consider proactive interventions to address nurses' insomnia and foster a workplace with healthy systems and culture to reduce sleep disturbance and presenteeism, which can effectively decrease care left undone. REPORTING METHOD: STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

3.
J Adv Nurs ; 2024 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-39304300

RESUMO

AIMS: To compare nurses' and patients' reports of missed nursing care, explore patients' perspectives and utilise these insights to elucidate discrepancies or congruence between perceptions. DESIGN: A descriptive mixed-methods design combining quantitative (questionnaires) and qualitative (semi-structured interviews) methods. METHODS: In the quantitative phase, 143 nurses and 643 patients completed the MISSCARE and MISSCARE-Patient surveys. Correlations between their total missed care scores were examined. In the qualitative phase, 68 patients participated in semi-structured interviews analysed using thematic analysis. RESULTS: The correlation between nurses' and patients' perceptions of missed nursing care was nonsignificant. Qualitative findings revealed three themes: (1) patients' need to preserve individuality; (2) most patients attributed missed care to systemic factors, while some attributed it to nurses' attitudes and (3) emotional responses varied from empathetic understanding, inadvertently enabling more missed care, to frustration and assertiveness to ensure receiving necessary care. CONCLUSIONS: This study reveals a significant discrepancy between nurses' and patients' perceptions of missed care. Patient perspectives offer insights into this misalignment, highlighting differences in care priorities and role understanding. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Enhancing nurse-patient communication and patient empowerment are crucial. Healthcare institutions should integrate patient feedback into quality initiatives, create supportive work environments and foster a patient-centred care culture. Effectively marketing nurses' expertise and implementing strategies to manage patient assertiveness are essential. IMPACT: This study addresses the discrepancy in perceptions of missed nursing care between nurses and patients. It reveals how patients' care priorities and attributions influence their experience of missed care. Findings will impact healthcare policymakers, nursing educators and hospital administrators, informing strategies to improve care quality, patient satisfaction and nurse work environments across healthcare settings. REPORTING METHOD: The study has adhered to STROBE guidelines for the quantitative component and SRQR guidelines for the qualitative component. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

4.
J Clin Nurs ; 2024 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-38380764

RESUMO

AIM: To describe Australian perioperative nurses' reported frequency and reasons for missed nursing care in the operating room. DESIGN: Cross-sectional online survey conducted in March-April 2022. METHODS: A census of Australian perioperative nurses who were members of a national professional body were invited to complete a survey that focussed on their reported frequency of missed nursing care and the reasons for missed nursing care in the operating room using the MISSCare Survey OR. RESULTS: In all, 612 perioperative nurses completed the survey. The perioperative and intraoperative nursing care tasks reported as most frequently missed included time-intensive tasks and communication with multiple surgical team members present. The most frequently reported reasons for missed care were staffing-related (e.g. staff number, skill mix, fatigue and complacency) and affected teamwork. There were no significant differences in the frequency of missed care based on perioperative nurse roles. However, there were statistically significant differences between nurse management, circulating/instrument nurses and recovery room nurses in reasons for missed care. CONCLUSIONS: Much of the missed care that occurs in the operating room is related to communication practices and processes, which has implications for patient safety. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Understanding the types of nursing care tasks being missed and the reasons for this missed care in the operating room may offer nurse managers deeper insights into potential strategies to address this situation. REPORTING METHOD: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

5.
J Clin Nurs ; 33(9): 3399-3413, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38661121

RESUMO

AIM(S): Teamwork among healthcare professionals is a key aspect of patient safety that influences the prevalence of missed nursing care. The association between teamwork and missed care in acute care hospitals is now well established in the literature. Therefore, this review aimed to synthesise the existing empirical evidence on the association between teamwork and missed care in the acute care setting. DESIGN: A mixed-method systematic review study. METHODS: The search was carried out in February 2023 in four scientific databases, PubMed, ProQuest, Web of Science and Scopus based on their institutional availability. The search produced 1542 studies. The method of thematic analysis was used in data synthesis. RESULTS: A total of 18 studies were selected that revealed the relationship between teamwork and missed care. The teamwork score was weak to moderate but significantly associated with the overall score of missed care and was found to be a statistically significant predictor of missed care in an acute care setting. Additionally, teamwork represented an important reason for missed care, primarily in the context of poor communication, lack of trust and cooperation in the nursing team and lack of leadership. CONCLUSION: The review findings contribute to a deeper understanding of the intricate dynamics between teamwork and missed care and provide valuable information to healthcare professionals and institutions looking to optimise teamwork and mitigate instances of missed care in the acute care setting. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Recognising how teamwork influences the occurrence of missed care, healthcare organisations can strategically implement targeted interventions to enhance collaboration, address communication gaps, foster trust, and provide effective leadership. IMPACT: This review suggests that improving teamwork seems to be one of the most important strategies focused on mitigating missed care in acute care settings. REPORTING METHOD: The reporting of this review followed the PRISMA 2020 checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.


Assuntos
Equipe de Assistência ao Paciente , Humanos , Cuidados de Enfermagem/normas , Cuidados de Enfermagem/estatística & dados numéricos , Segurança do Paciente
6.
J Clin Nurs ; 2024 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-39209794

RESUMO

Moral sensitivity, missed nursing care and moral distress among healthcare professionals have received considerable attention in recent years. These factors represent important healthcare challenges for new nurses (graduation to 2 years of work experience). However, studies on the relationships among these variables in the context of new nurses in China remain lacking. AIMS: To explore the relationships among moral sensitivity, missed nursing care and moral distress in the context of new nurses in China. RESEARCH DESIGN: A cross-sectional descriptive survey was conducted. PARTICIPANTS AND RESEARCH CONTEXT: A total of 228 new nurses were recruited from three tertiary hospitals in Qingdao, Shandong Province, China. Participants provided their sociodemographic and professional information and completed the Chinese Moral Sensitivity Questionnaire-Revised Version, the Chinese Missed Nursing Care Survey Version and the Chinese Moral Distress Scale-Revised Version. The data were analysed using Spearman's correlation analysis and multiple linear regression analysis. RESULTS: The means and standard errors of moral sensitivity, missed nursing care and moral distress were 40.71 (0.39), 9.82 (0.78) and 34.87 (2.41), respectively. The variable of missed nursing care exhibited a significant negative relationship with moral sensitivity and a significant positive relationship with moral distress. Regression analysis revealed that the main factors influencing new nurses' moral distress were educational background, nature of job, current unit, frequency of night shifts and the dimensions of moral strength and responsibility. These factors can explain 14.9% of the total variation. CONCLUSION: The findings revealed that higher rates of missed nursing care were associated with lower moral sensitivity and greater moral distress among new nurses. Therefore, developing interventions to reduce missed nursing care may be a promising strategy for improving moral sensitivity and preventing moral distress among new nurses. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: In hospitals, moral distress can be improved by focusing on modifiable factors such as staffing resources, leading to better promoting new nurses' health and improving the quality of care. This study can highlight practices accounting for moral sensitivity and missed nursing care in nursing research and training programmes. REPORTING METHOD: Strengthening the reporting of observational studies in epidemiology (STROBE) statement. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

7.
J Clin Nurs ; 33(9): 3576-3585, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-38284458

RESUMO

AIMS AND OBJECTIVE: To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care. BACKGROUND: Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence. DESIGN: Descriptive and correlational design. METHODS: The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1-12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist. RESULTS: The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care. CONCLUSIONS: Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses. RELEVANCE TO CLINICAL PRACTICE: The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education.


Assuntos
Competência Clínica , Enfermagem Holística , Humanos , Feminino , Masculino , Competência Clínica/estatística & dados numéricos , Competência Clínica/normas , Adulto , Análise de Mediação , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/psicologia , Inquéritos e Questionários , Cuidados de Enfermagem/estatística & dados numéricos , Cuidados de Enfermagem/normas
8.
J Clin Nurs ; 2024 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-38923756

RESUMO

AIMS: To examine a novel moderated-mediation model, investigating whether personal accountability moderates the link between nurse workload and missed nursing care and whether missed nursing care mediates the association between workload and moral distress. DESIGN: Nested diary study. METHODS: Data spanning from February 2019 to February 2023 were collected from 137 nurses working in various inpatient wards in two medium-sized hospitals. Nurses reported care given to specific patients on three to five occasions across different shifts, establishing nurse-patient dyads. Validated measures of missed nursing care, personal accountability, moral distress and workload were analyzed using mixed linear models to test the nested moderated-mediation model. RESULTS: Under high workload conditions, nurses with higher personal accountability reported lower frequencies of missed nursing care compared to those with lower personal accountability. In contrast, under low workload conditions, personal accountability did not significantly influence missed nursing care occurrences. Furthermore, the interaction between workload and personal accountability indirectly affected nurses' moral distress through missed nursing care. Specifically, higher personal accountability combined with lower missed nursing care contributed to reduced levels of moral distress among nurses. CONCLUSION: The study highlights accountability's dual role-safeguarding against care omissions and influencing nurses' moral distress amid rising workload pressures. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: Cultivating a culture of accountability within healthcare settings can serve as a protective factor against the negative effects of workload on patient care quality and nurse psychological distress, highlighting the need for organizational interventions to promote accountability among nursing staff. IMPACT: By recognizing accountability's pivotal role, organizations can implement targeted interventions fostering accountability among nurses, including training programs focused on enhancing responsibility/ownership in care delivery and creating supportive environments prioritizing accountability to achieve positive patient outcomes. REPORTING METHOD: The study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

9.
J Clin Nurs ; 2024 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-39072931

RESUMO

AIMS: To investigate the interrelationships of patient safety, caring behaviours, professional self-efficacy and missed nursing care among emergency room nurses. DESIGN: Cross-sectional, correlational study. METHODS: Filipino emergency room nurses (n = 345) participated via convenience sampling from September 2023 to January 2024. Four validated self-report scales were used to collect data and were analysed using Spearman rho, covariance-based structural equation modelling, mediation and path analyses. RESULTS: The emerging model of study variables displayed satisfactory fit indices. Patient safety directly influenced caring behaviours and professional self-efficacy, while negatively influencing missed nursing care. Caring behaviours directly and indirectly affected professional self-efficacy and missed nursing care, respectively. Professional self-efficacy negatively influences missed nursing care. Finally, caring behaviours and professional self-efficacy were significant mediators between the association of patient safety and missed nursing care. CONCLUSION: Caring behaviours and professional self-efficacy of emergency room nurses demonstrated mediating effects that can potentially improve patient safety practices thereby minimizing unfinished or missed nursing care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses and healthcare organizations should commit to consistently maintain a workplace culture that fosters patient safety, caring behaviours and professional self-efficacy to minimize avoidable injuries and omitting nursing care tasks. REPORTING METHOD: STrengthening the Reporting of OBservational studies in Epidemiology (STROBE). PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

10.
J Pediatr Nurs ; 78: e404-e410, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39112121

RESUMO

PURPOSE: This study investigates the relationship between burnout levels of moral distress and missed nursing care in pediatric nurses. DESIGN AND METHOD: A cross-sectional study was conducted between November and December 2023. Pediatric nurses working in two hospitals and providing direct care to children (n = 140) completed the Moral Distress Scale-Revised Pediatric Nurses, MISSCARE Survey - Pediatric Version and Burnout Measure-Short Version questionnaire. Multivariate regression analysis modeling was applied to test the mediating effect on the relationship between burnout, moral distress, and missed nursing care. RESULTS: There was a significant positive correlation between the Moral Distress Scale-Revised Pediatric Nurses and its sub-dimensions and the Burnout Measure-Short Version (p < 0.05). There was a significant positive correlation between the mean MISSCARE- Survey-Ped score of the nurses participating in the study and its sub-dimensions and Burnout Measure-Short Version (p < 0.05). Providing Benefit-Do No Harm, one of the Moral Distress Scale-Revised Pediatric Nurses sub-dimensions, and Labour Resources, one of the MISSCARE sub-dimensions, were found to be predictors of burnout. The ethical principle of Providing Benefit-Do No Harm was found to mediate between moral distress and burnout and reduce burnout associated with missed care. CONCLUSIONS: Accordingly, as the nurses' moral distress and inability to meet the necessary patient care increase, their burnout levels also increase. Providing Benefit-Do No Harm is an basic ethical principle that will positively affect the burnout level of pediatric nurses. PRACTICE IMPLICATIONS: This study may provide insights into ethics training, communication improvement strategies, and individual support intervention programs aimed at reducing moral distress, and burnout and improving the coping mechanisms of nurses working in pediatric wards.


Assuntos
Esgotamento Profissional , Recursos Humanos de Enfermagem Hospitalar , Enfermagem Pediátrica , Humanos , Esgotamento Profissional/psicologia , Feminino , Estudos Transversais , Masculino , Adulto , Recursos Humanos de Enfermagem Hospitalar/psicologia , Inquéritos e Questionários , Enfermeiros Pediátricos/psicologia
11.
Scand J Caring Sci ; 2024 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-39129432

RESUMO

INTRODUCTION: First-line managers in Swedish communities have responsibility for that care to older people is provided, staffing is sufficient and the budget is balanced in their unit. It is a struggle with limited resources due to a growing population in need of care. This can lead to missed nursing care. The aim was to describe first-line managers´ perceptions of missed nursing care in community health care for older people. METHODS: A qualitative design with a phenomenographic approach, interviewing 24 first-line managers. Ethics approval for the study was received from the Research Ethics Committee at Karlstad University (Dnr HNT 2020/566). RESULTS: The results are shown in six descriptive categories containing 15 perceptions. The descriptive categories are 'occurrence of missed nursing care', 'becoming aware of missed nursing care', 'reasons for missed nursing care', 'missed nursing care has consequences for the older persons', 'missed nursing care has consequences for the staff' and 'taking action to decrease missed nursing care'. CONCLUSIONS: It is important for first-line managers to become aware of the existence and reasons for missed nursing, as it has consequences for older people and staff. Managers need to take missed nursing care seriously in order to work with improvements for maintaining good quality of care and patient safety.

12.
Public Health Nurs ; 2024 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-39287366

RESUMO

OBJECTIVE: To develop and validate a questionnaire to evaluate missed nursing care (MNC) in a home care setting. DESIGN: A new instrument was developed and tested performing a preliminary analysis of a multicenter cross-sectional study in Italy. Reporting was performed according to COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines. SAMPLE: Eight hundred out of a total of 2549 home care nurses enrolled in AIDOMUS-IT were considered for the validation of the Missed Nursing Care in Home Care (MNC_HC). MEASUREMENTS: The MNC_HC instrument was developed by a panel of experts and underwent content and face validation. Exploratory (EFA) and confirmatory factor analyses (CFA) were conducted. RESULTS: EFA revealed a one-factor solution, explaining 56% of the total variance for MNC_HC. CFA confirmed excellent structural validity, with a one-factor model showing an exceptional fit (χ2 (27) = 141.39, p < .001, RMSEA = 0.04, SRMR = 0.04, CFI = 0.99, TLI = 0.99, factor loadings > 0.5). MNC_HC also demonstrated high reliability (Cronbach's α = 0.92). The activity with the highest rate of missed care was the documentation of nursing care (77%), while activities related to nursing techniques (e.g., injections, dressings, etc.) were reported to be missed less (33.63%). CONCLUSIONS: MNC_HC is a quick-filling, valid, reliable, and psychometrically sound instrument for measuring MNC in home care useful for future research.

13.
BMC Nurs ; 23(1): 169, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38475743

RESUMO

BACKGROUND: Missed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients' needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses' moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran. METHODS: A cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis. RESULTS: Most participants (52.97%) showed moderate moral sensitivity. Nurses' mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (ß = 0.213, p < 0.001), age (ß = 0.131, p < 0.001), working in rotating shifts (ß = 0.183, p < 0.001), monthly income (ß = 0.079, p = 0.004), work experience (ß = 0.030, p = 0.010), and monthly work hours (ß = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables. CONCLUSION: Our nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly.

14.
BMC Nurs ; 23(1): 388, 2024 Jun 06.
Artigo em Inglês | MEDLINE | ID: mdl-38844989

RESUMO

BACKGROUND: When any aspect of patient care is overlooked or delayed, it is known as Missed Nursing Care (MNC), leading to adverse events such as medication errors, infections, increased mortality rates, and poor prognosis. Moral competence is crucial for clinical nurses as it guarantees high-quality patient care in nursing practice. Thus, this study aimed to investigate the correlation between moral competencies and MNC among nurses. METHODS: This study was conducted with a descriptive-correlational design. The participants in the study were nurses who were currently enrolled at Shahid Beheshti University of Medical Sciences. In order to recruit nurses for the study, a convenience sampling method was implemented. The study tools were completed by a total of two hundred nurses. Research tools included a demographic questionnaire, the Moral Competence of Clinical Nurses Questionnaire, and the Kalisch and Williams Missed Nursing Care (MISSCARE) survey. ETHICAL CONSIDERATION: This study was approved by the Medical Ethics and Law Research Center of Shahid Beheshti University of Medical Sciences. RESULTS: The mean scores of moral competencies and MNC were 151.83 ± 12.60 and 42.71 ± 9.38, respectively. In other words, descriptive statistics showed that the moral competence score was more than 75%, and the MNC score was less than 50%. Also, there was a significant negative correlation between the total scores of moral competencies and MNC (r = -0.38, p < 0.001), indicating that more moral competence was correlated with lower levels of MNC. CONCLUSION: The study revealed a negative correlation between nurses' moral competence and MNC, suggesting that enhancing moral competence could reduce MNC. To reduce MNC occurrences, hospitals, and organizations should prioritize moral competency, according to our research.

15.
BMC Nurs ; 23(1): 652, 2024 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-39272086

RESUMO

BACKGROUND: Missed nursing care poses a significant challenge for healthcare staff in terms of patient safety and care quality. OBJECTIVE: To evaluate presenteeism and missed care attitudes of nurses and to determine the correlation between presenteeism and missed care. METHODS: This descriptive, correlational, and observational study was conducted between February and August 2023. The Stanford Presenteeism Scale-Short Form and the MISSCARE Survey were used to collect the data among nurses at two public hospitals in a city in Turkey. The study was completed with 229 nurses representing 27.4% of the total number of nurses who met the inclusion criteria. The data was analyzed using a comprehensive analytical approach, including Cronbach's alpha analysis, frequency and percentage distribution, the Shapiro-Wilk test of normality, correlation coefficient analysis, Pearson correlation coefficient, and the Bonferroni test. RESULTS: The participants' mean age was 30.22 ± 7.14 years, and 74.2% of them were female. 53.3% of the participants reported difficulty providing patient care due to material shortages, and 62.9% experienced challenges delivering care due to the intensity of paperwork in the clinic. Nurses who felt that paperwork intensity affected patient care and were not confident in their care provision had higher levels of presenteeism (p = 0.041) and a significantly higher frequency of missed care instances (p < 0.001). CONCLUSIONS: Material shortages and high paperwork intensity are contributing factors to the difficulties experienced by nurses in their practice. These difficulties may lead to an increase in presenteeism and instances of missed nursing care. It is important to address these challenges to ensure adequate care provision and reduce the likelihood of presenteeism among nurses. The correlation between presenteeism and instances of missed nursing care highlights the impact of presenteeism behaviors on the quality of patient care.

16.
BMC Nurs ; 23(1): 233, 2024 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-38584285

RESUMO

BACKGROUND: Missed nursing care occurs globally, and the consequences are severe for the patients when fundamental care needs are not fulfilled, nor delivered in a person-centred way. This study aimed to investigate the occurrence and cause of missed nursing care, and the relationship between registered nurses' and nursing assistants' perceptions of missed nursing care, in a surgical care context. METHODS: A quantitative study was performed using the MISSCARE survey, measuring missed nursing care and associated reasons, in three surgical wards with registered nurses and nursing assistants as the participants (n = 118), during May-November in 2022. The MISSCARE survey also covers background data such as job satisfaction and intention to leave. The survey was distributed paper-based and the response rate was 88%. RESULTS: Aspects of nursing care rated to be missed the most were 'attending interdisciplinary care conferences', 'turning patient every 2 h', 'ambulation 3 times per day or as ordered', and 'mouth care'. Differences between registered nurse and nursing assistant ratings were detected for eight out of 24 items, where registered nurses rated more missed nursing care. The uppermost reasons for missed nursing care were 'inadequate number of staff' and 'unexpected rise in patient volume and/or acuity on the unit'. Registered nurses and nursing assistants rated differently regarding six of 17 items. Almost every fourth staff member (24.6%, n = 29) had the intention to leave within a year in the present department. CONCLUSIONS: The occurrence of missed nursing care is frequent in the surgical context, and in combination with a high number of staff members intending to leave their employment, poses a hazard to patient safety. Registered nurses, holding higher educational levels, reported more missed care compared with the nursing assistants. The main reason for missed nursing care was an inadequate number of staff. These findings support a warranted investment in nursing within the organisation. The results can be used to form strategies and interventions, to reduce nurse attrition and optimise competence utilisation, and to achieve safe person-centered fundamental care.

17.
BMC Nurs ; 23(1): 165, 2024 Mar 07.
Artigo em Inglês | MEDLINE | ID: mdl-38454469

RESUMO

BACKGROUND: Missed nursing care is a pervasive issue in hospitals, nursing homes, and communities, posing a significant threat to patient safety and the quality of nursing care. It has adverse effects on patient satisfaction and the motivation of nursing staff. Understanding the causes and nature of these care omissions in clinical settings is essential for implementing effective interventions. This study aims to develop and validate a tool for assessing missed nursing care in adult intensive care units. METHODS: Semi-structured interviews, expert consultations conducted via the Delphi method and item analysis were used to develop the initial scale. Our analysis involved data collected from 400 nurses and employed correlation coefficient analysis, critical ratio assessment, Cronbach's α coefficient evaluation, discrete trend analysis, and factor analysis, which were grounded in both classical test theory and item response theory, allowing us to scrutinize and refine the items in the scale. To validate the scale, we conveniently sampled 550 nurses and assessed structural validity, internal reliability, split-half reliability, and test-retest reliability to ensure the scale's robustness and accuracy. RESULTS: The Missed Intensive Nursing Care Scale (MINCS) comprises three distinct components. Part A serves to collect general information about the participants. In Part B, the missed care elements are categorized into five domains, following the framework of Maslow's hierarchy of needs theory: physiology, safety, belongingness, esteem, and cognition. Part C is dedicated to detailing the reasons behind missed care, which encompass labor resources, material resources, communication factors, and managerial factors. Remarkably, the Cronbach's α coefficient for the MINCS stands at an impressive 0.951, with S-CVI values of 0.988 and 0.977 in Part B and C, respectively, underscoring the scale's exceptional reliability and validity. This demonstrates the scale's effectiveness in measuring missed nursing care while upholding rigorous standards of quality. CONCLUSIONS: The MINCS emerges as a robust and dependable instrument for quantifying instances of missed care within the ICU. Its efficacy makes it a valuable resource for informing the development of strategies aimed at averting and mitigating the adverse effects associated with missed nursing care.

18.
J Emerg Nurs ; 50(3): 392-402, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38310494

RESUMO

INTRODUCTION: This descriptive cross-sectional study describes missed nursing care, quality of care, and patient safety rated by nursing staff in emergency departments. Required patient care that is omitted or delayed (missed nursing care) is associated with poorer quality of care and increased risk for adverse events, but studies are scarce in the emergency setting. METHODS: Emergency registered nurses and nursing assistants (N=126) at 2 Swedish emergency departments participated in the study. The MISSCARE survey-Swedish version was used for data collection. RESULTS: Emergency nursing staff assessed that nursing care is frequently missed in the emergency department. More than half of the 24 nursing care items were reported as missed by over 50% of the participants, and registered nurses rated most items significantly higher compared to nursing assistants. Half of the nursing staff perceived quality of care to be good, but nearly the same proportion perceived patient safety as poor. Registered nurses viewed both quality and safety worse than nursing assistants. DISCUSSION: The present study found very high levels of missed nursing care in most nursing items. Results indicate that nursing staff in emergency departments need to prioritize between the tasks and that some tasks may not be relevant in the context. The emergency setting focuses primarily on identifying signs of urgency, assessing patients, performing interventions, and diagnostics. However, even items that seemed to be prioritized, such as reassessment of vital signs, had a surprisingly high level of missed nursing care in comparison to in-hospital wards.


Assuntos
Enfermagem em Emergência , Serviço Hospitalar de Emergência , Recursos Humanos de Enfermagem Hospitalar , Qualidade da Assistência à Saúde , Humanos , Estudos Transversais , Suécia , Feminino , Masculino , Adulto , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Pessoa de Meia-Idade , Segurança do Paciente , Inquéritos e Questionários , Atitude do Pessoal de Saúde
19.
Z Gerontol Geriatr ; 2024 Sep 06.
Artigo em Alemão | MEDLINE | ID: mdl-39240384

RESUMO

BACKGROUND: The current evidence regarding interventions to improve oral health in older hospital patients is unclear. OBJECTIVE: This scoping review assesses the scope and nature of research activities and identifies gaps in the existing literature. METHODS: The inclusion criteria for this study included adults over the age of 65 years who were treated as inpatient outside of intensive care units and covered all interventions aimed at promoting oral health or hygiene. RESULTS: The systematic search yielded 12 final studies, focusing on oral healthcare interventions in various settings, primarily in high-income countries. The studies employed diverse designs including randomized controlled trials and prospective studies, with interventions mainly provided by multidisciplinary teams. The interventions aimed to improve oral health or prevent pneumonia. Overall, the studies highlighted a potential effectiveness of multidisciplinary approaches in improving oral health and preventing pneumonia in geriatric populations. CONCLUSION: This scoping review shows a limited and heterogeneous evidence base for oral health interventions for older patients in hospitals. The need for patient involvement is evident; however, there is often a lack of high-quality studies to draw robust conclusions.

20.
Int Nurs Rev ; 2024 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-39051554

RESUMO

AIM: To examine the relationship between missed nursing care and conscientious intelligence. BACKGROUND: Missed nursing care is a globally common patient safety issue that threatens quality nursing care. Current studies mainly focus on the relationship between missed nursing care and external factors such as nurse, unit and hospital characteristics. However, internal factors, such as the conscientious intelligence of nurses, are also very important for missed nursing care. Moreover, the relationship between missed nursing care and conscientious intelligence has not been examined so far. This study will contribute to filling this gap in the literature. METHODS: This is a descriptive correlational study. The study sample consisted of 514 nurses working in a city in the southeastern region of Türkiye, reached by convenience sampling method. Study data were collected between 30 January and 30 June 2021. Descriptive statistics, difference statistics, Pearson correlation analysis and multiple regression analysis were performed. RESULTS: Nurses missed nursing care at an occasional level (1.66 ± 0.63), and their conscientious intelligence score was high (131.26 ± 19.24). Conscientious intelligence alone accounted for 10.6% of the variance in missed nursing care. As nurses' conscientious intelligence levels increase, the level of missed nursing care decreases. Gender, education level, satisfaction with being a nurse and patient-to-nurse ratios had a statistically significant effect on missed nursing care scores. CONCLUSION: Missed nursing care decreased as nurses' conscientious intelligence increased. Although nurses need to be knowledgeable and competent in caregiving, it is also necessary to consider their conscientious intelligence in patient care. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Organizations and nurse managers could improve nursing care by implementing strategies to increase nurses' conscientious intelligence. For this, they would need to encourage nurses to receive training on sensitivity, awareness, ethical decision-making and ethical sensitivity. Moreover, nurse managers should be role models and leaders in compliance with personal and professional values and ethical standards to improve nursing care.

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