Missed Nursing Care as a Quality Indicator During Transition to a Dedicated Education Unit Model

A cross-sectional study of the relationship between missed nursing care and conscientious intelligence in hospital nurses

AIM

To examine the relationship between missed nursing care and conscientious intelligence.

BACKGROUND

Missed nursing care is a globally common patient safety issue that threatens quality nursing care. Current studies mainly focus on the relationship between missed nursing care and external factors such as nurse, unit and hospital characteristics. However, internal factors, such as the conscientious intelligence of nurses, are also very important for missed nursing care. Moreover, the relationship between missed nursing care and conscientious intelligence has not been examined so far. This study will contribute to filling this gap in the literature.

METHODS

This is a descriptive correlational study. The study sample consisted of 514 nurses working in a city in the southeastern region of Türkiye, reached by convenience sampling method. Study data were collected between 30 January and 30 June 2021. Descriptive statistics, difference statistics, Pearson correlation analysis and multiple regression analysis were performed.

RESULTS

Nurses missed nursing care at an occasional level (1.66 ± 0.63), and their conscientious intelligence score was high (131.26 ± 19.24). Conscientious intelligence alone accounted for 10.6% of the variance in missed nursing care. As nurses' conscientious intelligence levels increase, the level of missed nursing care decreases. Gender, education level, satisfaction with being a nurse and patient-to-nurse ratios had a statistically significant effect on missed nursing care scores.

CONCLUSION

Missed nursing care decreased as nurses' conscientious intelligence increased. Although nurses need to be knowledgeable and competent in caregiving, it is also necessary to consider their conscientious intelligence in patient care.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Organizations and nurse managers could improve nursing care by implementing strategies to increase nurses' conscientious intelligence. For this, they would need to encourage nurses to receive training on sensitivity, awareness, ethical decision-making and ethical sensitivity. Moreover, nurse managers should be role models and leaders in compliance with personal and professional values and ethical standards to improve nursing care.

Missed nursing care and its relationship with nurses' moral sensitivity: a descriptive-analytical study

BACKGROUND

Missed care rates are an indicator of healthcare quality. Missed nursing care can reduce patient safety and lead to adverse events. Moral sensitivity enables nurses to interpret and respond to clients' needs according to ethical principles. Despite the importance of moral sensitivity and its role in the quality of care, the relationship between nurses' moral sensitivity and missed nursing care has not been extensively studied. This raises the question of whether there is an association between nurses' moral sensitivity and missed care. This study was conducted to investigate the relationship between nurses' moral sensitivity and missed nursing care in the medical and surgical departments of Imam Khomeini Hospital in Urmia, Iran.

METHODS

A cross-sectional study was conducted in 2022, on 202 nurses working in the medical and surgical departments of Imam Khomeini Medical Education Center, Urmia, Iran. Stratified random sampling was used to select the participants. A questionnaire on demographic characteristics, Kalisch's missed care questionnaire, and Lutzen's moral sensitivity questionnaire were used to collect data. Data were analyzed using the Pearson correlation test and linear regression analysis.

RESULTS

Most participants (52.97%) showed moderate moral sensitivity. Nurses' mean moral sensitivity and total missed care scores were 149.07 ± 21.60 and 59.45 ± 4.87, respectively. Pearson correlation test showed no significant correlation between moral sensitivity scores and the total missed care scores (r = 0.041, p = 0.152). However, in the regression analysis, moral sensitivity (β = 0.213, p < 0.001), age (β = 0.131, p < 0.001), working in rotating shifts (β = 0.183, p < 0.001), monthly income (β = 0.079, p = 0.004), work experience (β = 0.030, p = 0.010), and monthly work hours (β = 0.247, p = 0.010) influenced missed care. Approximately, 0.98% of the variance in the missed care was explained by these variables.

CONCLUSION

Our nurses reported moderate levels of moral sensitivity and a concerning level of missed care. Missed care can have detrimental effects on patient safety. Therefore, nursing managers must address this issue promptly.

Frequency, reasons, correlates and predictors of missed nursing care in Turkey: A multi-hospital cross-sectional study

AIM

We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey.

METHODS

This descriptive and cross-sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey-Turkish and the MISSCARE Survey-Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data.

RESULTS

The total occurrence of missed nursing care was 2.93 (on a scale of 1.00-4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient-nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care.

CONCLUSIONS

The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient-nurse ratio and nursing teamwork to reduce the incidence of missed nursing care.