Missed Nursing Care: Incidence and predictive factors

• Autor(a) principal: Paiva, Ivo Cristiano Soares
• Data de Publicação: 2018
• Outros Autores: Moreira, Isabel Maria Pinheiro Borges, Amaral, António Fernando Salgueiro
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/info:doi:https://doi.org/10.1186/s12913-018-3444-8
• topic: Missed Nursing Care

Background The increasing complexity and demand in health care, together with patients' changing needs, put into evidence the need for nurses to focus their interventions on people's real needs, thus rethinking their role. In this context, unfinished, delayed, or missed nursing care (MNC), which is a strong indicator of health care quality, can compromise quality care and patient safety. Objective To identify the most common MNC, as well as its predictors and strategies to prevent its occurrence. Methods A systematic literature review was conducted on studies available in the EBSCOhost and B-on databases. Twenty-four articles were selected based on predefined criteria. All articles were published between 2012 and 2017. Results The studies showed that nurses and patients have different perceptions about MNC. Autonomous interventions related to early mobility and walking, repositioning every 2 hours, or oral and body hygiene are more often missed than interdependent interventions. [1-5]. Medication administration within 30 minutes of prescription, planning and update of care plans, vital signs monitoring, and treatment effectiveness assessment also emerged as MNC [5-7]. Predictive factors are associated with the patient (health status/workload) [2, 5]; the nurse (interruptions by other professionals or patients' relatives) [4, 8]; the materials or equipment (late deliveries) [9], or the hospital's health care policies (management/leadership and staffing) [10]. The nurse-patient/family communication emerged as MNC, whereas the nurse-other health professional communication emerged as a predictive factor because teamwork and its effectiveness are compromised [2, 11]. Nurses' personal interests and moral sense can influence the occurrence of MNC. Therefore, the strategies used to reduce the incidence of MNC should be adjusted to the needs of each setting [2, 5]. Conclusions Although MNCs are being explored internationally, it is an understudied topic in Portugal, which may be explained by the punitive error reporting culture. The findings cannot be generalized due to the diversity of studies. Thus, the phenomenon of MNC and its impact on patient/family prognosis should be explored in different settings, with the purpose of achieving excellence in health care and ensuring that people recognize the importance of health care.