Missed Nursing Care: The Impact on Patients, Nurses and Organisations

Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.

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The impact of the nursing practice environment on missed nursing care

Clinical Nursing Studies ◽

10.5430/cns.v3n4p60 ◽

2015 ◽

Vol 3 (4) ◽

Cited By ~ 20

Author(s):

Amanda J Hessels ◽

Linda Flynn ◽

Jeannie P. Cimiotti ◽

Edna Cadmus ◽

Robyn R.M. Gershon

Keyword(s):

Nursing Care ◽

Nursing Practice ◽

Practice Environment ◽

Nursing Practice Environment ◽

Missed Nursing Care ◽

The Impact

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Missed nursing care and its relationship with perceived ethical leadership

Nursing Ethics ◽

10.1177/09697330211006823 ◽

2021 ◽

pp. 096973302110068

Author(s):

Gülşah Gürol Arslan ◽

Dilek Özden ◽

Gizem Göktuna ◽

Büşra Ertuğrul

Keyword(s):

Nursing Care ◽

Ethical Leadership ◽

Significant Relationship ◽

Cultural Context ◽

Ethics Committee ◽

Factors Affecting ◽

Number Of Patients ◽

Missed Care ◽

Missed Nursing Care ◽

The Impact

Background: Determination of the factors affecting missed nursing care and the impact of ethical leadership is important in improving the quality of care. Aim: This study aims to determine the missed nursing care and its relationship with perceived ethical leadership. Research design: A cross-sectional study. Participants and research context: The sample consisted of 233 nurses, of whom 92.7% were staff nurses and 7.3% were charge nurses, who work in three different hospitals in Turkey. The study data were collected using a personal and professional characteristics data form, the Missed Nursing Care Survey, and the Ethical Leadership Scale. Ethical considerations: The study was approved by the non-interventional ethics committee of Dokuz Eylül University Ethics Committee for Noninvasive Clinical Studies. All participants’ written and verbal consents were obtained. Findings: The most missed nursing care practices were ambulation, attending interdisciplinary care conferences, and discharge planning. According to the logistic regression analysis, sex, the number of patients that the nurse is in charge of giving care, the number of patients discharged in the last shift, and satisfaction with the team were determined as factors affecting missed care. No significant relationship was found between ethical leadership and missed nursing care (p > 0.05), and a weak but significant relationship was found between the clarification of duties/roles subscale and missed nursing care (r = −0.136, p < 0.05). Discussion: Ethical leaders should collaborate with policy-makers at an institutional level to particularly achieve teamwork that is effective in the provision of care, to control missed basic nursing care, and to organize working hours and at the country level to determine roles and to increase the workforce. Conclusion: The results of this study contribute to the international literature on the most common type of missed nursing care, its reasons, and the relationship between the missed care and ethical leadership in a different cultural context.

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