Factors Affecting Nursing Surveillance Activity among Clinical Nurses

Missed nursing care and its associated factors among nursing students: A cross-sectional study

BACKGROUND

Nursing students are often curious about the match between their theoretical knowledge and the nursing care they observe during their clinical practices. Discrepancies between them can lead to instances where nursing care is omitted. If this omission is frequent, students may perceive it as a norm. Assessing missed nursing care among nursing students can provide input to improve clinical education and quality of nursing care. However, there is a lack of research on missed nursing care among nursing students in Ethiopia.

OBJECTIVE

To assess missed nursing care and its associated factors among nursing students in Ethiopia.

METHODS

A cross-sectional study was conducted from April 7 to June 22, 2024, at two universities in Ethiopia. Nursing students who had completed at least one clinical placement were included. Convenience sampling was used to recruit 358 participants. A validated 'Unfinished Nursing Care Survey for Students (UNCS4S)' scale was used to measure missed nursing care. Data were analysed using SPSS version 29 software. Multiple linear regression analysis was used to identify factors associated with missed nursing care at a P value of ≤0.05.

RESULTS

The average score of missed nursing care was 3.03 [95 % CI: 2.98; 3.08]. Teaching patients (Mean = 3.71, 3.58; 3.83 CI), providing personal hygiene (Mean = 3.70, 3.57; 3.83 CI), and emotional support (Mean = 3.62, 3.51; 3.73 CI) were most frequently missed. Lack of collaboration among nurses (β = 2.165, 1.040; 3.29 CI), inadequate number of nurses (β = 3.166, 0.711; 5.621 CI), insufficient supervision of tasks (β = 1.344, 0.453; 2.236 CI), inaccurate initial priority setting (β = 1.043, 0.107; 1.979 CI), and inadequate nursing care model (β = 1.211, 0.160; 2.261 CI) were factors associated with missed nursing care.

CONCLUSIONS

Nursing students reported a high level of missed nursing care. Hospital administrators should address nursing staff shortages, strengthen teamwork among nurses, and improve supervision of nursing tasks to mitigate missed nursing care and improve patient safety. There is a need to review whether existing nursing curricula sufficiently integrate missed nursing care and its potential impacts to enhance students' awareness and preparedness for their future practices. Future qualitative research is needed to explore students' personal experiences with missed care and reactions when they observe it and explore its impacts on their education and attitudes toward nursing.

Testing the validity and reliability of the Korean nursing surveillance scale: a methodological study

BACKGROUND

Because of the importance of nursing surveillance, there is a need to develop a scale to measure nursing surveillance that reflects the roles of nurses in South Korea. This study aimed to develop a scale to measure surveillance by Korean nurses and to test its reliability and validity.

METHODS

In the development phase, a literature review was conducted to verify the attributes of nursing surveillance, and preliminary items were developed based on the surveillance activities in the Nursing Intervention Classification (NIC) and the interviews of Korean nurses and modified through content validation and a pilot study. In the psychometric testing phase, two surveys were conducted with Korean nurses working in acute hospitals, using the preliminary scale in exploratory factor analysis (EFA, n = 220) and confirmatory factor analysis (CFA, n = 219). Data were analyzed through EFA, CFA, correlation, and reliability analyses to verify convergent validity, discriminant validity, criterion validity, and reliability. To verify the validity of the preliminary scale, the exploratory factor analysis and confirmatory factor analysis convergent validity, discriminant validity, criterion validity, and reliability were performed.

RESULTS

In the EFA, 16 items were grouped into four factors, accounting for 70.1% of the cumulative variance. In the CFA, the model exceeded the criteria for all fit indices (χ2 = 155.62 [df = 94, p < .001], CMIN = 1.65, SRMR = .048, RMSEA = .055, GFI = .921, NFI = .916, TLI = .955, CFI = .964) and was acceptable. The convergent validity, discriminant validity, criterion validity, and reliability were verified. The final Korean nursing surveillance scale consists of four factors: 'anticipation of problems and decision-making' with six items; 'systematic assessment' with five items; 'recognition of patterns' with three items; and 'identification of the patient's self-care and coping strategies' with two items.

CONCLUSION

The Korean nursing surveillance scale developed in this study comprised questions that included NIC's surveillance activities and empirical data from Korean nurses; based on the attributes of nursing monitoring derived from concept analysis, its validity and reliability were verified. This study can provide precedent to motivate the development of nursing surveillance scales in other countries, and ultimately stimulate studies on nursing surveillance, which is essential for patient safety.

Nursing students' perceptions of unfinished nursing care: A cross-sectional study

AIM

To investigate the prevalence, patterns and reasons for unfinished nursing care as perceived by nursing students.

BACKGROUND

Unfinished nursing care (UNC) is a frequently observed phenomenon in the acute care setting. To date, studies have focused primarily on the perspective of nurses or patients, but another important perspective is that of nursing students who provide nursing care in all healthcare settings.

DESIGN

A descriptive cross-sectional study.

METHODS

The study included 738 undergraduate nursing students from nine Slovak universities. Data were collected between September 2022 and February 2023 using the Slovak version of the Unfinished Nursing Care Survey tool (UNCS). Data were analyzed using descriptive and inferential statistics.

RESULTS

The mean composite score of UNCS was 2.48 (SD=0.68). In general, 100% of nursing students reported that nurses missed at least one or more nursing care activities during their last clinical placement. The average number of missed nursing care activities was 11.2 per nurse as perceived by nursing students during their last clinical placement. Nursing students reported that the most frequently omitted nursing care activity was spending time with patients and their caregivers (3.15 ± 1.11; 92.9%). The most frequently reported reason for UNC was an inadequate number of nurses on the ward (4.31 ± 1.01; 98.1%). In the study, reported UNC could be predicted by previous experience in healthcare, previous clinical rotation, number of patients per shift, perceived staff adequacy and outcome expectations (p <0.05).

CONCLUSIONS

The findings reveal that UNC is a widespread phenomenon and all nursing students report this phenomenon during their clinical placements. Spending time with patients and their caregivers emerged as the most frequently omitted nursing care activity, highlighting the importance of patient-centered care. The primary reason cited for UNC was an inadequate number of nurses, highlighting staffing issues as a significant contributing factor. These findings emphasize the need for targeted interventions to address staff shortages and improve nursing education to prepare students to address UNC in their future practice.