Aims and objectives
Systematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes.
Background
A considerable body of evidence supports the ...hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear.
Design
Systematic review.
Methods
We searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review.
Results
Fourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged.
Conclusions
The review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self‐reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required.
Relevance to clinical practice
Although nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.
•Patients fundamental care needs is of risk of being missed in the Emergency Departments.•One cause for Missed Nursing Care is a high patient input leading to a nurse-to-patient imbalance.•Missed ...nursing care likely have consequences for the quality of care and patient safety in Emergency departments.
Patient safety is a global health priority. Errors of omission, such as missed nursing care in hospitals, are frequent and may lead to adverse events. Emergency departments (ED) are especially vulnerable to patient safety errors, and the significance missed nursing care has in this context is not as well known as in other contexts.
The aim of this scoping review was to summarize and disseminate research about missed nursing care in the context of EDs.
A scoping review following the framework suggested by Arksey and O’Malley was used to (1) identify the research question; (2) identify relevant studies; (3) select studies; (4) chart the data; (5) collate, summarize, and report the results; and (6) consultation.
In total, 20 themes were derived from the 55 included studies. Missed or delayed assessments or other fundamental care were examples of missed nursing care characteristics. EDs not staffed or dimensioned in relation to the patient load were identified as a cause of missed nursing care in most included studies. Clinical deteriorations and medication errors were described in the included studies in relation to patient safety and quality of care deficiencies. Registered nurses also expressed that missed nursing care was undignified and unsafe.
The findings from this scoping review indicate that patients’ fundamental needs are not met in the ED, mainly because of the patient load and how the ED is designed. According to registered nurses, missed nursing care is perceived as undignified and unsafe.
İntramusküler enjeksiyon çeşitli komplikasyonların gelişmesine neden olan önemli bir hemşirelik uygulamasıdır. Bu komplikasyonların önlenmesi için göz önünde bulundurulması gereken birçok faktör ...vardır. Gordon’un Fonksiyonel Sağlık Örüntüleri Modeli, bireylerin gereksinimlerini 11 fonksiyonel alanda ele alarak bireylere kapsamlı bakım verilmesini ve bütüncül olarak değerlendirilmesini sağlamaktadır. Bu olgu sunumunda dorsagluteal bölgeden intramusküler enjeksiyon yapılması nedeni ile komplikasyon gelişen hastanın Gordon’un Fonksiyonel Sağlık Örüntüleri Modeline göre hemşirelik bakımı yer almaktadır. Olgunun verileri, hasta bakımı sırasında yapılan gözlemler ve hasta ile yapılan görüşmelerden elde edilerek toplanmış, modele göre bakım içeriği planlanmış, uygulanmış ve değerlendirilmiştir.
We investigated the time perspective and mental health of students without school attendance difficulties in junior high school immediately after they entered senior high school in order to identify ...the factors those contribute to high school adjustment. The results showed that lower emotional distress and higher positive present perspective were positively correlated with lower feelings of school avoidance. Furthermore, a positive past perspective enhanced self-esteem, which in turn reduced distress and led a positive present perspective. It is, therefore, suggested that improving a negative past perspective and enhancing self-esteem are crucial for students of newly entering senior high school.
In this study, we analyzed how the focus of research has changed in dementia caregiving research in Japan, targeting academic information titles with the keywords "dementia and caregiving" in the ...database CiNii. Text Mining Studio 6.3.0 was used for the analysis. The amount of academic information in the database gradually increased from the 1980s, reaching a peak in 2004. Before the name change, until 2003, the focus was on the medical view and the disease, not the patients themselves; after 2004, the focus was on the intentions and inner life of the dementia patients themselves, and the patients have been taking part in the care team.
Aim
To explore the emotional impact and experiences of geriatric nurses working in nursing homes and caring for patients with coronavirus 2019 disease (COVID‐19).
Design
This is a qualitative study ...with phenomenological method and data were gathered through in‐depth interview.
Methods
The experiences and expectations that nurses are facing during their care duties were explored via video conference, using a semi‐structured interview guide. We have followed the Consolidated criteria for reporting qualitative research COREQ.
Results
Interviews (N=24) were conducted with nurses from four countries (Spain, Italy, Peru, and Mexico) during April 2020. Three main categories were extracted: fear of the pandemic situation, the sense of duty and professional commitment, and emotional exhaustion.
Conclusions
Regardless of the country and situation, in the face of the pandemic, dramatic situations have been experienced in nursing homes worldwide, with nursing staff feeling exhausted and overwhelmed, and reflection is urged on a global level to consider the most appropriate model of care in nursing homes.
摘要
目的
探讨养老院老年护士看护新冠肺炎患者的情绪影响及经历。
设计
通过深度访谈为该项使用现象法开展的定性研究进行数据搜集。
方法
通过视频会议,以半结构化访谈为指导,对护士在履行护理职责时的经历和所面临的期望进行了探讨。我们遵循了定性研究统一报告标准(COREQ)。
结果
2020年4月,我们对来自于四个不同国家(西班牙、意大利、秘鲁及墨西哥)的护士进行了采访,并由此得到了三类情绪:对疫情的害怕、职业及专业承诺和情绪疲乏。
结论
全球的养老院,不论位于哪一国、哪一疫情阶段,在新冠肺炎疫情下,都出现了令人揪心的状况,养老院的护理人员筋疲力尽且不堪负荷。此时,在全球范围内,都迫切需要一套最恰当的养老院护理模式。
影响
老年护士对养老院的受关注度及护理模式改进提出了更高要求。
现需采取措施预防并消除大流行给工作人员,尤其是一线护士的精神健康所带来的影响。
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