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Aldarawsheh AA, Saifan AR, Sawalha MA, Assaf EA, Alrimawi I, Elshatarat RA, Saleh ZT, Almagharbeh WT, Mohamed NA, Eltayeb MM. Exploring the causes and consequences of non-nursing tasks among nurses in Jordan: An in-depth qualitative investigation. Appl Nurs Res 2024; 77:151791. [PMID: 38796256 DOI: 10.1016/j.apnr.2024.151791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 04/05/2024] [Accepted: 04/05/2024] [Indexed: 05/28/2024]
Abstract
AIM To investigate the perceptions of Jordanian nurses regarding Non-Nursing Tasks (NNTs) and their consequences, as well as the underlying factors that contribute to the occurrence of NNTs. BACKGROUND Nurses play a crucial role in providing high-quality patient care, but they often engage in NNTs, which can hinder their ability to deliver care effectively. Western countries have primarily conducted research on NNTs, while Middle Eastern countries such as Jordan have received limited attention. Expanding our understanding of NNTs is essential for improving nursing care. METHODS A qualitative-exploratory approach was adopted. The research was conducted at three hospitals in Amman, Jordan. A purposeful sampling approach was used to select the participant and a focus group-interview method was used to gather the data. The derived data were analyzed using a thematic analysis approach. RESULTS The final sample of this study included 38 participants. The findings highlighted that nurses often perform NNTs due to staff shortages and limited resources, as well as weaknesses in nursing administration and education. The finding also highlights the consequences of NNTs on nurses' professional lives, including impaired nursing care, physical and mental health strain, and a lack of efficiency and productivity. CONCLUSIONS The present study's results provide valuable insights into the impact of NNTs on nurses in Jordan. These findings underscore the need for healthcare stakeholders to actively address the issue of NNTs. It also emphasized the need for more explicit job descriptions and processes, along with support for nurses to fulfilling their responsibilities and prioritizing patient care.
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Affiliation(s)
- Ayman Abed Aldarawsheh
- Intensive Critical Care Unit, Royal Medical Services, Prince Rashid Military Hospital, Irbid, Jordan
| | - Ahmad Rajeh Saifan
- Nursing Department, Faculty of Nursing College, Applied Science Private University, Aman, Jordan
| | - Murad Adnan Sawalha
- Department of Maternal, Child and Family Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Enas A Assaf
- Nursing Department, Faculty of Nursing College, Applied Science Private University, Aman, Jordan
| | - Intima Alrimawi
- School of Nursing, Georgetown University, Washington, DC, United States of America
| | - Rami A Elshatarat
- Department of Medical and Surgical Nursing, College of Nursing, Taibah University, Madinah, Saudi Arabia
| | - Zyad T Saleh
- Department of Clinical Nursing, School of Nursing, The University of Jordan, Amman, Jordan
| | - Wesam T Almagharbeh
- Medical Surgical Nursing Department, Faculty of Nursing, University of Tabuk, Tabuk, Saudi Arabia
| | - Nermen A Mohamed
- Department of Medical Surgical Nursing, College of Nursing, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia
| | - Mudathir M Eltayeb
- Department of Medical Surgical Nursing, College of Nursing, Prince Sattam bin Abdulaziz University, AlKharj, Saudi Arabia.
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Vincelette C, D'Aragon F, Stevens LM, Rochefort CM. Development and Validation Process of the Intensive Care Unit Omitted Nursing Care (ICU-ONC) Instrument Among French Canadian Nurses. J Nurs Meas 2024; 32:95-105. [PMID: 37348884 DOI: 10.1891/jnm-2022-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/24/2023]
Abstract
Background and Purpose: The purpose of this article is to document the development and validation process of an instrument adapted for French-speaking nurses and to measure the occurrence of omitted nursing care (ONC) in the intensive care unit (ICU). Methods: An electronic Delphi panel, involving ICU nursing experts from the province of Quebec (Canada), was used to develop the intensive care unit omitted nursing care (ICU-ONC) instrument. For the validation process, an electronic cross-sectional survey was conducted. Results: A total of 564 nurses participated in the validation study. Exploratory factor analysis performed on 478 complete observations supports the presence of a single-factor structure for the 22-item ICU-ONC instrument. Coefficient alpha for the scale was .93, 95% confidence interval (CI) was [0.92, 0.94], item-partial total correlations ranged from .49 and .68, and the mean/median interitem correlations were .38 and .37, respectively. Moderate negative correlations were found between the ICU-ONC instrument overall score and two related constructs: nurses' perception of the quality as well as the safety of care. Conclusions: Our current understanding of ONC in the ICU is based on the results drawn from the administration of generic instruments to ICU nurses. The novel 22-item ICU-ONC instrument can help better estimate the occurrence of the phenomena in the ICU.
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Affiliation(s)
- Christian Vincelette
- School of Nursing, Université de Sherbrooke, Longueuil, Quebec, Canada
- Research Center Charles-LeMoyne, Longueuil, Quebec, Canada
- Research Center du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Frédérick D'Aragon
- Research Center du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Anesthesiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Louis-Mathieu Stevens
- Department of Surgery, Faculté de Médecine, Université de Montréal, Montreal, Quebec, Canada
- Research Center Centre hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Christian M Rochefort
- School of Nursing, Université de Sherbrooke, Longueuil, Quebec, Canada
- Research Center Charles-LeMoyne, Longueuil, Quebec, Canada
- Research Center du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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El-Sayed AAI, Asal MGR, Shaheen RS, Abdelaliem SMF. Job embeddedness and missed nursing care at the operating theatres: the mediating role of polychronicity. BMC Nurs 2023; 22:458. [PMID: 38049777 PMCID: PMC10696744 DOI: 10.1186/s12912-023-01628-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Perioperative missed nursing care is a serious issue that can compromise patient safety and quality of care. However, little is known about the factors that influence perioperative missed nursing care. AIM This study aimed to examine the effects of job embeddedness and polychronicity on perioperative missed nursing care as well as to test the mediating role of polychronicity on the relationship between job embeddeness and perioperative missed nursing care. METHOD This was a cross-sectional correlational study that used a convenience sample of 210 operating room nurses from nine hospitals in Egypt. Data were collected using self-administered questionnaires that measured job embeddedness, polychronicity, and perioperative missed nursing care. Structural equation modeling was used to test the hypothesized relationships among the variables. RESULTS The findings demonstrated a significant negative and moderate association between missed perioperative care and both nurses' job embeddedness and polychronicity. Moreover, there was a moderately positive and significant correlation between polychronicity and job embeddedness. Path analysis revealed a significant positive causal effect between job embeddedness and polychronicity. The results of mediation revealed that the indirect effect of job embeddedness on missed care through polychronicity was statistically significant; suggesting that polychronicity partially mediated this relationship. CONCLUSION This study sheds light on the intricate relationship between nurses' job embeddedness, missed care, and polychronicity in the operating theater context. By enhancing job embeddedness and fostering polychronicity among nurses, healthcare organizations can reduce perioperative missed care and ultimately improve patient care outcomes in this critical healthcare setting.
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Affiliation(s)
| | - Maha Gamal Ramadan Asal
- Medical Surgical Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt.
| | - Rabab Saleh Shaheen
- Nursing Administration Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Vincelette C, D'Aragon F, Stevens LM, Rochefort CM. The characteristics and factors associated with omitted nursing care in the intensive care unit: A cross-sectional study. Intensive Crit Care Nurs 2023; 75:103343. [PMID: 36371393 DOI: 10.1016/j.iccn.2022.103343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/13/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Prior research showed that work environment features in acute care settings influence nurses' capacity to provide care and impacts patient outcomes (e.g., falls). However, little is known about this phenomenon in the intensive care unit. The objectives of this study were to describe the characteristics of omitted nursing care, and to examine the associations between work environment features, omitted nursing care and nurse-reported outcomes in the intensive care unit. METHODS An electronic cross-sectional correlational study was conducted in the province of Quebec, Canada. Over September 2021, nurses were asked to complete the Healthy Work Environment Assessment Tool (HWEAT), the Intensive Care Unit Omitted Nursing Care instrument (ICU-ONC) and to report their perceptions of nurse-reported outcomes (e.g., quality of care). The associations between these variables were estimated using multivariable cluster-robust regression models, adjusted for nurse and hospital characteristics. RESULTS A total of 493 nurses from 42 distinct hospitals participated to this study. On average, nurses felt that their work environment was acceptable, and that the quality and safety of patient care was good. Basic care activities (e.g., mobilisation) were most frequently reported as omitted as opposed to those related to surveillance and medical interventions. In multivariable analyses, higher work environment scores were associated with reduced omitted nursing care scores (p < 0.001) and better ratings for nurse-reported outcomes (p < 0.001). Also, higher omitted nursing care scores were associated with more negative perceptions about the quality and safety of care (p < 0.001). CONCLUSION Our study portrays the characteristics and some factors associated with omitted nursing care in the intensive care unit. Further research should determine whether intensive care nurses' reports of organisational features and omitted nursing care are associated with objectively captured patient outcomes.
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Affiliation(s)
- Christian Vincelette
- School of Nursing, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, Québec, Canada; Research Center Charles-LeMoyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Longueuil, Québec, Canada; Research Center du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada.
| | - Frédérick D'Aragon
- Research Center du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada; Department of Anesthesiology, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, Québec, Canada.
| | - Louis-Mathieu Stevens
- Department of surgery, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada; Research Center, Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada.
| | - Christian M Rochefort
- School of Nursing, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Longueuil, Québec, Canada; Research Center Charles-LeMoyne-Saguenay-Lac-Saint-Jean sur les innovations en santé, Longueuil, Québec, Canada; Research Center du Centre hospitalier Universitaire de Sherbrooke (CRCHUS), Sherbrooke, Québec, Canada.
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Imam A, Obiesie S, Gathara D, Aluvaala J, Maina M, English M. Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review. HUMAN RESOURCES FOR HEALTH 2023; 21:19. [PMID: 36918941 PMCID: PMC10015781 DOI: 10.1186/s12960-023-00807-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 02/23/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Missed nursing care undermines nursing standards of care and minimising this phenomenon is crucial to maintaining adequate patient safety and the quality of patient care. The concept is a neglected aspect of human resource for health thinking, and it remains understudied in low-income and middle-income country (LMIC) settings which have 90% of the global nursing workforce shortages. Our objective in this review was to document the prevalence of missed nursing care in LMIC, identify the categories of nursing care that are most missed and summarise the reasons for this. METHODS We conducted a systematic review searching Medline, Embase, Global Health, WHO Global index medicus and CINAHL from their inception up until August 2021. Publications were included if they were conducted in an LMIC and reported on any combination of categories, reasons and factors associated with missed nursing care within in-patient settings. We assessed the quality of studies using the Newcastle Ottawa Scale. RESULTS Thirty-one studies met our inclusion criteria. These studies were mainly cross-sectional, from upper middle-income settings and mostly relied on nurses' self-report of missed nursing care. The measurement tools used, and their reporting were inconsistent across the literature. Nursing care most frequently missed were non-clinical nursing activities including those of comfort and communication. Inadequate personnel numbers were the most important reasons given for missed care. CONCLUSIONS Missed nursing care is reported for all key nursing task areas threatening care quality and safety. Data suggest nurses prioritise technical activities with more non-clinical activities missed, this undermines holistic nursing care. Improving staffing levels seems a key intervention potentially including sharing of less skilled activities. More research on missed nursing care and interventions to tackle it to improve quality and safety is needed in LMIC. PROSPERO registration number: CRD42021286897.
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Affiliation(s)
- Abdulazeez Imam
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya.
- Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK.
| | - Sopuruchukwu Obiesie
- Centre for Evidence Based Intervention, Department of Social Policy and Intervention, University of Oxford, Oxford, UK
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Mike English
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Health Systems Collaborative, Nuffield Department of Medicine, University of Oxford, S Parks Rd, Oxford, OX1 3SY, UK
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An Overview of Missed Nursing Care and Its Predictors in Saudi Arabia: A Cross-Sectional Study. Nurs Res Pract 2022; 2022:4971890. [PMID: 36278115 PMCID: PMC9581685 DOI: 10.1155/2022/4971890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 09/12/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nursing care is holistic, and missing any aspect of care can be critical to patients' health. However, due to the complex and intense nature of the nursing practice, nurses have to unintentionally prioritize some activities, forcing them to omit some aspects of nursing care. Aim To explore the dimensions of missed nursing care and its predictors within the Saudi Arabian healthcare system. Methods Quantitative, cross-sectional study used the MISSCARE survey by utilizing nonprobability convenience sampling to collect the data of 604 staff nurses working in inpatient wards in Jazan, Saudi Arabia. Results The overall mean of missed nursing care is (m = 1.37, SD = 0.45). Missed nursing care activities were mostly failure to attend interdisciplinary care conferences (m = 1.66, SD = 0.96) and patient ambulation thrice a day (m = 1.63, SD = 0.97). Missed nursing care was mainly caused by human resource shortage (m = 3.53, SD = 0.88). Missed nursing care is predicted by the turnover intention (B = 2.380, t = 3.829, p < 001) and job satisfaction (B = −0.864, t = −4.788, p < 001). Conclusion Although missed nursing care is evident in Saudi Arabia, it is significantly lower than the international rates, and it is mainly caused by labor resource shortage which directly influences nurses' job satisfaction and intention to leave. Optimizing the recruitment process, resource allocation and effective nurses' retention programs are proposed solutions that may be beneficial to mitigate missed nursing care.
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Imam A, Obiesie S, Aluvaala J, Maina M, Gathara D, English M. Missed nursing care in acute care hospital settings in low-middle income countries: a systematic review protocol. Wellcome Open Res 2022; 6:359. [PMID: 35495089 PMCID: PMC9020529 DOI: 10.12688/wellcomeopenres.17431.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Missed nursing care (care left undone or task incompletion) is viewed as an important early predictor of adverse patient care outcomes and is a useful indicator to determine the quality of patient care. Available systematic reviews on missed nursing care are based mainly on primary studies from developed countries, and there is limited evidence on missed nursing care from low-middle income countries (LMICs). We propose conducting a systematic review to identify the magnitude of missed nursing care and document factors and reasons associated with this phenomenon in LMIC settings. Methods and analysis: This protocol was developed using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols (PRISMA-P). We will conduct literature searching across the Ovid Medline, Embase and EBSCO Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases, from inception to 2021. Two independent reviewers will conduct searches and data abstraction, and discordance will be handled by discussion between both parties. The risk of bias of the individual studies will be determined using the Newcastle-Ottawa Scale (NOS). Ethics and dissemination: Ethical permission is not required for this review as we will make use of already published data. We aim to publish the findings of our review in peer-reviewed journals PROSPERO registration number: CRD42021286897 (27 th October 2021).
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Affiliation(s)
- Abdulazeez Imam
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
| | | | - Jalemba Aluvaala
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- Department of Paediatrics, University of Nairobi, Nairobi, Kenya
| | - Michuki Maina
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - David Gathara
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
- MARCH Centre, London School of Hygiene and Tropical Medicine, London, UK
| | - Mike English
- Oxford Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, OX1 3SY, UK
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
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