scholarly journals Nurses' efforts to maintain competence: a qualitative study

2021 ◽  
Author(s):  
Nur Miladiyah Rahmah ◽  
Tutik Sri Hariyati ◽  
Junaiti Sahar
Keyword(s):  
Nursing Care ◽  
Clinical Competence ◽  
Nurse Managers ◽  
Continuing Professional Development ◽  
Nursing Services ◽  
Ensure Patient Safety ◽  
Missed Care ◽  
Qualitative Phenomenological ◽  
Missed Nursing Care ◽  
Competence System

Background: The clinical competence of nurses should be maintained to ensure patient safety. Competence is the integration of knowledge, skills, and attitudes. Nurse competency also improves the quality of nursing care and reduces the incidence of missed nursing care. This study aimed to explore the experiences of nurses maintaining a nurse competence system in hospitals through continuing education.Design and Methods: The research method used was qualitative phenomenological research, and the data was collected through an in-depth interview which was consist of six participants.Results: The results of the research were 1). continuing professional development to maintain the competence, 2) credentialing system in the career ladder system, 3). missed care still occurred in the implementation of nursing services 4). Nurses had hopes that managers supported the efforts to maintain competence through continuing professional development.Conclusion: Nurse managers are expected to improve the supervision program to maintain clinical competence and decrease missed care.

Missed nursing care and complexity theory: a conceptual paper

2021 ◽  
pp. 174498712110130
Author(s):  
Rania Ali Albsoul ◽  
Gerard FitzGerald ◽  
James A Hughes ◽  
Muhammad Ahmed Alshyyab
Keyword(s):  
Complexity Theory ◽  
Nursing Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Nurse Managers ◽  
Systems Approach ◽  
Complex Adaptive ◽  
Missed Care ◽  
Missed Nursing Care ◽  
The Impact

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.

Adaptation and Psychometric Testing of the Czech and Slovak Version of the Missed Nursing Care in Infection Prevention and Control Survey

2021 ◽  
pp. JNM-D-20-00044
Author(s):  
Elena Gurková ◽  
Ian Blackman ◽  
Daniela Bartoníčková ◽  
Darja Jarošová ◽  
Lenka Machálková ◽  
...  
Keyword(s):  
Infection Control ◽  
Nursing Care ◽  
Prevention And Control ◽  
Infection Prevention ◽  
Infection Prevention And Control ◽  
Reliability Estimates ◽  
Care Survey ◽  
Missed Care ◽  
Missed Nursing Care ◽  
And Control

Background and PurposeOnly a limited number of items involved in missed nursing care inventories specifically focused on infection control practices. The study aimed to adapt and evaluate psychometric properties of the Czech and Slovak version of the Infection Control Missed Care survey; and to assess and compare the amount, type, and reasons for missed nursing care in infection prevention and control among Czech and Slovak nurses.MethodsThe convenience sample of 1459 nurses from the Czech and Slovak republic was recruited. Analysis of the nurses' responses to both subscales of the surveys and validation of their data was undertaken using the item response theory (Rasch scaling).ResultsThe now-modified Czech version consists only of 20 items measuring the type and frequency of missed care and 11 items focusing on the reasons for missed care. The now modified Slovak version consists of 34 items measuring the type and frequency of missed care and 17 items measuring the reasons for missed care. Reliability estimates with the removal of unreliable items showed acceptable reliability estimates for both sub-scales of the instrument.ConclusionsWith modification to the two subscales used in the survey (removal of poorly fitting items) it should be reliable, and the resulting data could be used for further investigation such as factor analysis or modelling. The modified Infection Control Missed Care survey could be useful in further research investigating a relationship between nurse staffing, skill mix, and infection control outcomes in acute care hospitals.

scholarly journals Validation of the MISSCARE-BRASIL survey - A tool to assess missed nursing care

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Lillian Dias Castilho Siqueira ◽  
Maria Helena Larcher Caliri ◽  
Vanderlei José Haas ◽  
Beatrice Kalisch ◽  
Rosana Aparecida Spadoti Dantas
Keyword(s):  
Leadership Style ◽  
Internal Consistency ◽  
Nursing Care ◽  
Intraclass Correlation ◽  
Dimensional Structure ◽  
Survey Method ◽  
Validity And Reliability ◽  
Administrative Roles ◽  
Missed Care ◽  
Missed Nursing Care

ABSTRACT Objective: to analyze the metric validity and reliability properties of the MISSCARE-BRASIL survey. Method: methodological research conducted by assessing construct validity and reliability via confirmatory factor analysis, known-groups validation, convergent construct validation, analysis of internal consistency and test-retest reliability. The sample consisted of 330 nursing professionals, of whom 86 participated in the retest phase. Results: of the 330 participants, 39.7% were aides, 33% technicians, 20.9% nurses, and 6.4% nurses with administrative roles. Confirmatory factorial analysis demonstrated that the Brazilian Portuguese version of the instrument is adequately adjusted to the dimensional structure the scale authors originally proposed. The correlation between “satisfaction with position/role” and “satisfaction with teamwork” and the survey’s missed care variables was moderate (Spearman’s coefficient =0.35; p<0.001). The results of the Student’s t-test indicated known-group validity. Professionals from closed units reported lower levels of missed care in comparison with the other units. The reliability showed a strong correlation, with the exception of “institutional management/leadership style” (intraclass correlation coefficient (ICC)=0.15; p=0.04). The internal consistency was adequate (Cronbach’s alpha was greater than 0.70). Conclusion: the MISSCARE-BRASIL was valid and reliable in the group studied. The application of the MISSCARE-BRASIL can contribute to identifying solutions for missed nursing care.

Evaluating the Performance of a Single-Item, Global, Estimate of Missed Nursing Care

2017 ◽  
Vol 25 (1) ◽  
pp. 121-141 ◽  
Author(s):  
Patti Hamilton ◽  
Eileen Willis ◽  
Terry Jones ◽  
Rhonda McKelvie ◽  
Ian Blackman ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Nursing Care ◽  
Convergent Validity ◽  
Characteristic Curve ◽  
Quality Care ◽  
Poor Quality ◽  
Single Item ◽  
Missed Care ◽  
Missed Nursing Care ◽  
Poor Quality Care

Background and Purpose: Current measures of missed nursing care employ inventories of tasks which are rated for the frequency with which each is missed. These lists have shortcomings for research and clinical evaluation. There is a need for measures with less response burden, wider generalizability, and greater sensitivity and specificity for identifying poor quality care. Methods: We tested a single-item, global, measure using data from a large study of missed care in Australia. We employed traditional and innovative analysis techniques such as receiver operating characteristic curve and item response theory. Results: The single-item measure had adequate concurrent and convergent validity when compared to one list-format measure of missed care and strong sensitivity and specificity for identifying poor quality care. Conclusions: A well-crafted single-item measure, such as the one tested, can be useful for measuring missed nursing care.

scholarly journals Factors influencing the missed nursing care in patients from a private hospital

2017 ◽  
Vol 25 (0) ◽  
Author(s):  
Raúl Hernández-Cruz ◽  
María Guadalupe Moreno-Monsiváis ◽  
Sofía Cheverría-Rivera ◽  
Aracely Díaz-Oviedo
Keyword(s):  
Human Resources ◽  
Nursing Care ◽  
Private Hospital ◽  
Related Factors ◽  
Basic Care ◽  
Missed Care ◽  
Missed Nursing Care ◽  
Spearman’S Correlation ◽  
Care Index ◽  
Main Factor

ABSTRACT Objective: to determine the factors that influence the missed nursing care in hospitalized patients. Methods: descriptive correlational study developed at a private hospital in Mexico. To identify the missed nursing care and related factors, the MISSCARE survey was used, which measures the care missed and associated factors. The care missed and the factors were grouped in global and dimension rates. For the analysis, descriptive statistics, Spearman’s correlation and simple linear regression were used. Approval for the study was obtained from the ethics committee. Results: the participants were 71 nurses from emergency, intensive care and inpatient services. The global missed care index corresponded to M=7.45 (SD=10.74); the highest missed care index was found in the dimension basic care interventions (M=13.02, SD=17.60). The main factor contributing to the care missed was human resources (M=56.13, SD=21.38). The factors related to the care missed were human resources (rs=0.408, p<0.001) and communication (rs=0.418, p<0.001). Conclusions: the nursing care missed is mainly due to the human resource factor; these study findings will permit the strengthening of nursing care continuity.

Missed Care in Neonatal Intensive Care Unit: Effect of Eletronic Reminders  

2020 ◽  
Author(s):  
Fereshteh Bahrami ◽  
Mansooreh Azizzadeh Forouzi ◽  
Monirsadat Nematollahi ◽  
Beatrice Kalisch J. ◽  
Behnaz Bagherian
Keyword(s):  
Nursing Care ◽  
Neonatal Intensive Care ◽  
Information Technologies ◽  
Low Cost ◽  
Intervention Group ◽  
Sampling Technique ◽  
Control Group ◽  
Before And After ◽  
Missed Care ◽  
Missed Nursing Care

Abstract Background: Missed nursing care is a newly defined concept and refers to any aspect of required patient care that is omitted or delayed. This study aimed to determine the effectiveness of electronic reminders on missed care in NICU.Methods: This is a two groups (before and after) quasi experimental study. A random sampling technique was employed to collect a sample of 70 nurses among two NICUs in an educational hospital in the south east of Iran. Miss care questionnaire was used to determine Missed care before, immediate, and one month after the intervention. The study intervention includes sending electronic reminders regarding nursing care of NICU hospitalized neonate. Data were analyzed using SPSS20 software, descriptive (frequency, percentage, mean, and standard deviation), and analytical statistics. The level of significance was considered as 0.05.Results: The results showed that the mean score of missed care was decreased after intervention in the intervention group (6.74±8.47) rather than the control group (18.57±14.59) (P=0.001). The highest and the lowest mean score of missed care before and after the intervention was in general care and oxygen therapy domains in both groups. The second time intervention was one month after did not show any significant differences in the two groups. But decreasing in missed care was shown in both groups.Conclusion: using information technologies like whatsApp is an easy, low cost and available method which could help nurses decrease missed nursing care.

Ethical climate and missed nursing care in cancer care units

2016 ◽  
Vol 25 (6) ◽  
pp. 707-723 ◽  
Author(s):  
Stavros Vryonides ◽  
Evridiki Papastavrou ◽  
Andreas Charalambous ◽  
Panayiota Andreou ◽  
Christos Eleftheriou ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Work Environment ◽  
Nursing Care ◽  
Cancer Care ◽  
Ethical Climate ◽  
Relevant Literature ◽  
Survey Tool ◽  
Missed Care ◽  
Republic Of Cyprus ◽  
Missed Nursing Care

Background: Previous research has linked missed nursing care to nurses’ work environment. Ethical climate is a part of work environment, but the relationship of missed care to different types of ethical climate is unknown. Research objectives: To describe the types of ethical climate in adult in-patient cancer care settings, and their relationship to missed nursing care. Research design: A descriptive correlation design was used. Data were collected using the Ethical Climate Questionnaire and the MISSCARE survey tool, and analyzed with descriptive statistics, Pearson’s correlation and analysis of variance. Participants and research context: All nurses from relevant units in the Republic of Cyprus were invited to participate. Ethical considerations: The research protocol has been approved according to national legislation, all licenses have been obtained, and respondents participated voluntarily after they have received all necessary information. Findings: Response rate was 91.8%. Five types identified were as follows: caring (M = 3.18, standard deviation = 1.39); law and code (M = 3.18, standard deviation = 0.96); rules (M = 3.17, standard deviation = 0.73); instrumental (M = 2.88, standard deviation = 1.34); and independence (M = 2.74, standard deviation = 0.94). Reported overall missed care (range: 1–5) was M = 2.51 (standard deviation = 0.90), and this was positively (p < 0.05) related to instrumental (r = 0.612) and independence (r = 0.461) types and negatively (p < 0.05) related to caring (r = −0.695), rules (r = −0.367), and law and code (r = −0.487). Discussion: The reported levels of missed care and the types of ethical climates present similarities and differences with the relevant literature. All types of ethical climate were related to the reported missed care. Conclusion: Efforts to reduce the influence of instrumental and independence types and fostering caring, law and code, and rules types might decrease missed nursing care. However, more robust evidence is needed.

Ethics of rationing of nursing care

2016 ◽  
Vol 25 (5) ◽  
pp. 591-600 ◽  
Author(s):  
Zahra Rooddehghan ◽  
Zohreh Parsa Yekta ◽  
Alireza N Nasrabadi
Keyword(s):  
Nursing Care ◽  
Nurse Managers ◽  
Qualitative Content Analysis ◽  
Care Patient ◽  
Negative Consequences ◽  
Face To Face ◽  
Clinical Nurses ◽  
Patient Dissatisfaction ◽  
Life Phenomena ◽  
Missed Nursing Care

Background: Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values. Objectives: The present research sought to explore aspects of rationing nursing care in Iran. Research design: This study applied qualitative content analysis, a method to explore people’s perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions. Participants and research context: The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran. Ethical considerations: The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants. Findings: According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses’ feeling of guilt. Conclusion: Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people’s lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon are warranted.

Abstract P861: The Perception of Missed Nursing Care in Patients With Acute Stroke

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Patricia A Zrelak
Keyword(s):  
Nursing Care ◽  
Central Venous Access ◽  
Summary Score ◽  
Indwelling Catheter ◽  
Unique Type ◽  
Mortality And Morbidity ◽  
Iatrogenic Complications ◽  
Care Survey ◽  
Missed Care ◽  
Missed Nursing Care

Background: “ Missed nursing care” is a unique type of error known as medical underuse. These errors of omission are related to events, such as patient falls, nosocomial infections, and pressure injuries, associated with increased stroke mortality and morbidity. This study aimed to measure the phenomena of missed care in patients with stroke from the perspective of staff RNs working on a stroke unit and neuro intensive care unit at a Comprehensive Stroke Center. Methods: A Missed Care Survey was developed. Building on the work by Kalisch, the new Missed Care Survey focused entirely on nurse-sensitive measures and related evidence-based bundle steps. Two versions of the 25- question ordinal survey were developed, differing only in how the responses were worded. One asked how often care was missed [never missed (5), rarely missed (4), occasionally missed (3), frequently missed (2), always missed (1)]. and the other how frequently care was completed [always completed (5),usually completed (4), etc.).Descriptive statistics were used to evaluate results. Staff volunteered to take the survey during an annual stroke review class, rating their perception of care over the last 30-days. The IRB determined that the human subject regulation did not apply. Results: Completion rate was 93% (n=140). Differences between the two surveys were minimal with the overall summary score being the same (4.1; range 3.5-4.5). Individual scores ranged from 2.6 to 5. Items most frequently described as never missed included timely administration of pre-operative antibiotics and use of barrier precautions with central venous access device insertion. Care most missed included bathing and peri-care (with/without indwelling catheter), mobility, incentive spirometry, and the prevention of loops in urinary drainage catheter tubing. There were minor changes in rankings between the two survey versions. Conclusions: Scores reflect that known interventions to prevent iatrogenic complications are frequently or occasionally missed (or only usually and occasionally completed). Next steps include validation with real time observations. When missed care is not addressed, it can become routine, known as normalization of deviance, negatively impacting patient outcomes and the quality of care.

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