Aim
To support the development of appropriate policies and actions in the field of missed nursing care (MNC).
Background
There has been an ever‐growing international debate on MNC, interventions that ...nurses have identified as necessary for their patients, but which for various reasons they are unable to provide or are forced to delay. Despite MNC's relevance, its translation into policies and actions has not been documented to date.
Method
A consensus development method was employed involving (a) a nominal group composed of experts in the field, policymakers and the President of the Regional Nursing Professional Boards, and (b) 218 nurses appointed primarily at the managerial levels.
Results
A total of eight consensus statements were approved and organized in a series of sub‐statements designed to (1) render the concept of MNC culturally acceptable in the Italian context, with the agreement that compromised nursing care (CNC) is the best term to be used in this field, as a synonym for MNC; (2) measure CNC as a strategy to increase patient safety; (3) select an appropriate CNC measurement tool; (4) optimize CNC measurement; (5) conduct effective CNC data analysis; (6) design and implement interventions to prevent and/or minimize CNC; (7) assess and disseminate findings on interventions' effectiveness; and (8) provide final remarks on the way to move forward.
Conclusions
We developed a process to introduce the phenomenon of MNC in the Italian culture and agreed firstly on the term compromised nursing care, which better reflects MNC's meaning according to the context and facilitates an open discussion on the phenomenon both within and outside the profession. The following consensus statements emerged represent a systematic approach, starting from the measurement and finishing with the re‐measurement of the occurrence of MNC after having implemented concrete actions.
Implications for Nursing Management
The approved consensus statements can guide decision‐makers to develop concrete policies and actions that promote the improvement of quality of care and patients' safety by minimizing and/or preventing MNC's occurrence.
Background:
It is necessary to find ways to mediate the relationship between role overload and missed nursing care in settings where nursing staffing is inadequate. This study aimed to identify the ...single and multiple sequential mediation effects of organizational support, nurse-physician collaboration, and nurse-nurse collaboration on the relationship between role overload and missed nursing care.
Methods:
Data were collected from 237 registered Korean nurses working in general wards in October 2022. The measures used were the modified role overload scale, nurse-physician collaboration scale, nurse-nurse collaboration scale, a short version of the Perceived Organizational Support Scale, and the modified Missed Nursing Care Scale. Data were analyzed using PROCESS macro in SPSS. A hypothesis test was performed using Model 81, proposed by Hayes, which includes serial multiple mediators.
Results:
Organizational support, nurse-physician collaboration, and nurse-nurse collaboration showed a mediation effect on missed nursing care. Organizational support, nurse-physician collaboration, and nurse-nurse collaboration showed significant multiple sequential mediation effects on the relationship between role overload and missed nursing care. When the indirect effect sizes of nurse-physician collaboration were compared with those of nurse-nurse collaboration in both single and multiple sequential mediation paths, the indirect effect of nurse-physician collaboration was greater than that of nurse-nurse collaboration on the relationship between role overload and missed nursing care.
Conclusions:
As an alternative strategy to reduce missed nursing care in situations with insufficient nursing staffing, organizational support should precede nurse-physician and nurse-nurse collaboration. In particular, improving nurse-physician collaboration shows promise in mitigating missed nursing care.
Introduction: A coronavirus pandemic confirmed that respiratory nurses are critical healthcare providers. Knowledge about appropriate education for quality respiratory nursing care is limited. The ...ERS Nurses Chair formed the ICRN group to develop a core curriculum for respiratory nurses.
Aims: The study surveyed the need for an international core respiratory nursing curriculum and current curricula that exist globally.
Methods: A 39-item survey was sent to 33 respiratory nursing experts in 27 countries. Items included current roles, perception of need/expectations for a core curriculum, and respiratory content in nursing education in their countries.
Results: Thirty responses from 25 countries were analyzed; participants worked in academia (53%)/clinical practice (40%). The need for a core respiratory nursing curriculum was confirmed (97%). Post-registration nursing programs at bachelor (63.3%) and masters (43.3%) levels included internal/medical nursing care; less than half identified separate respiratory nursing content. Consensus was that a core educational program should include knowledge (70%), skills (60%), and competencies (50%), with separate pediatric and adult content.
Conclusion: The vast variation in formal respiratory nursing education globally confirms the need for a core respiratory curriculum. The ICRN will next use a Delphi study to identify core curricular elements for respiratory nursing education.
Speaking of service Broome, Marion E.; Snethen, Julia A.
Nursing outlook,
November-December 2022, 2022 Nov-Dec, 2022-11-00, 20221101, Letnik:
70, Številka:
6
Journal Article
Aims
A discussion of an optimal set of indicators that can be used on a priority basis to assess the performance of nursing care.
Background
Recent advances in conceptualization of nursing care ...performance, exemplified by the Nursing Care Performance Framework, have revealed a broad universe of potentially nursing‐sensitive indicators. Organizations now face the challenge of selecting, from this universe, a realistic subset of indicators that can form a balanced and common scorecard.
Design
Discussion paper drawing on a systematic assessment of selected performance indicators.
Data sources
Previous works, based on systematic reviews of the literature published between 1990 ‐ 2014, have contributed to the development of the Nursing Care Performance Framework. These works confirmed a robust set of indicators that capture the universe of content currently supported by the scientific literature and cover all major areas of nursing care performance. Building on these previous works, this study consisted in gathering the specific evidence supporting 25 selected indicators, focusing on systematic syntheses, meta‐analyses and integrative reviews.
Implications for nursing
This study has identified a set of 12 indicators that have sufficient breadth and depth to capture the whole spectrum of nursing care and that could be implemented on a priority basis.
Conclusions
This study sets the stage for new initiatives aiming at filling current gaps in operationalization of nursing care performance. The next milestone is to set up the infrastructure required to collect data on these indicators and make effective use of them.
Aims
To develop and validate a comprehensive tool based on those established in the field capable of reflecting the broader concept of Unfinished Nursing Care.
Background
Different tools have been ...established in the field of Missed Care, Rationing Care and Tasks Left Undone. However, despite them sharing similar items and all referring to the common concept of Unfinished Nursing Care, no attempts to collapse them in a single tool capable of reflecting current nursing practice, and its increased complexity, have been attempted to date.
Methods
A development and validation study was performed in 2017. After developing the instrument starting from the MISSCARE Survey and critically reviewing the other tools available in the field, the Unfinished Nursing Care Survey (UNCS) was subjected to validation. A total of 1977 nurses from 13 acute Italian hospitals were recruited. Acceptability, construct validity (Mokken Scaling, Explorative and Confirmative Factor Analysis), internal consistency, hypothesis testing and criterion validity were assessed according to the COnsensus‐based Standards for the selection of health Measurement INstruments guideline.
Results
1,400 (70.8%) nurses participated. The UNCS is composed of part A (=elements of unfinished care) and part B (=reasons for unfinished care) with 21 and 18 items, respectively. The UNCS has showed high acceptability (>90%). Part A has reported a strong scalability (H = .52), thus suggesting a hierarchical structure among the items. The six factors in part B explained a total variance of 64.3% (internal consistency = .806) as confirmed by the Confirmative Factor Analysis.
Conclusions
The comprehensive nature of the UNCS can contribute to the establishment of a common reference measure of the phenomenon worldwide although its psychometric properties require future investigation in different cultural contexts, languages and clinical settings.
Implications for Nursing Management
Measuring Unfinished Nursing Care provides information on the processes implicated in the development of adverse events before these become visible; moreover, it can increase awareness on nurses' performance and inform appropriate interventions to improve it.
OBJECTIVES
To examine the relationship between registered nurse (RN) burnout, job dissatisfaction, and missed care in nursing homes.
DESIGN
Cross‐sectional secondary analysis of linked data from the ...2015 RN4CAST‐US nurse survey and LTCfocus.
SETTING
A total of 540 Medicare‐ and Medicaid‐certified nursing homes in California, Florida, New Jersey, and Pennsylvania.
PARTICIPANTS
A total of 687 direct care RNs.
MEASUREMENTS
Emotional Exhaustion subscale of the Maslach Burnout Inventory, job dissatisfaction, and missed care.
RESULTS
Across all RNs, 30% exhibited high levels of burnout, 31% were dissatisfied with their job, and 72% reported missing one or more necessary care tasks on their last shift due to lack of time or resources. One in five RNs reported frequently being unable to complete necessary patient care. Controlling for RN and nursing home characteristics, RNs with burnout were five times more likely to leave necessary care undone (odds ratio OR = 4.97; 95% confidence interval CI = 2.56‐9.66) than RNs without burnout. RNs who were dissatisfied were 2.6 times more likely to leave necessary care undone (OR = 2.56; 95% CI = 1.68‐3.91) than RNs who were satisfied. Tasks most often left undone were comforting/talking with patients, providing adequate patient surveillance, patient/family teaching, and care planning.
CONCLUSION
Missed nursing care due to inadequate time or resources is common in nursing homes and is associated with RN burnout and job dissatisfaction. Improved work environments with sufficient staff hold promise for improving care and nurse retention. J Am Geriatr Soc 67:2065–2071, 2019
Aim
To identify the factors affecting nurses' patient safety competency under the new nursing care delivery model.
Background
In Korea, a new model was introduced in 2013 to ensure that nursing ...personnel provided inpatients with care without relying on guardians. After the launch of this service, there continue to be nurse‐related patient safety incidents.
Methods
This is a descriptive study. Data from 132 general hospital nurses were collected during 15–24 February 2017 and analysed using hierarchical multiple regression.
Results
Participants' mean patient safety competency score was 3.82 (range 1–5). Clinical career (Pratt index = 47.3%), critical thinking disposition (30.4%), teamwork (24.1%) and critical thinking training experience (7.3%) were found to affect nurses' patient safety competency.
Conclusion
Under the new model, new nurses showed a low level of patient safety competency. Clinical career most influenced patient safety competency. Enhanced critical thinking and teamwork training are needed to improve patient safety competency among nurses.
Implications for nursing management
Nursing leaders must consider qualitative staffing mix involving appropriate placement of experienced nurses as well as quantitative staffing level to provide patients with high‐quality, safe care and to implement the new model successfully. Regular training on critical thinking and teamwork should be carried out.
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