Omitted-missing nursing care in hospital – a pilot study

Česká verzia

Authors: A. Polanská ¹; D. Jarošová ²; E. Janíková ^1,2; E. Mynaříková ¹; I. Plevová ²; R. Zeleníková ²
Authors place of work: Fakultní nemocnice Ostrava, Útvar ošetřovatelské péče, Náměstkyně: PhDr. Andrea Polanská ¹; Ostravská univerzita v Ostravě, Lékařská fakulta, Ústav ošetřovatelství a porodní asistence, Vedoucí: prof. PhDr. Darja Jarošová, Ph. D. ²
Published in the journal: Prakt. Lék. 2020; 100(4): 192-195
Category: Of different specialties

Summary

Introduction: The term omit-ted-missing nursing care is a new term in this profession, Czech and Slovak nurses do not know the term or its meaning. One of the reasons is that the omitted nursing care is not a commonly used term in any country, and it is very difficult to start using it without a deeper understanding of the term. The omitted-missing nursing care is not the only term used to describe the phenomenon of a failure to provide certain aspects of the required standard nursing care. Several other terms are used in literature, such as "unfinished nursing care", "assigned nursing care" or "nursing care allocation".

Omitted-missing nursing care causes failure to provide the patient with necessary nursing activities. This increases the risk of adverse negative events in patients leading to increased healthcare costs.

Objective: To find out the perception of omitted-missing nursing care and the working environment by nurses, to find out the satisfaction of patients with the nursing care provided and the occurrence of undesirable events in connection with nursing care.

Methods: Data were collected in two standard wards of a large hospital. PIRNCA-CZ was used to determine the omitted nursing care perceived by nurses. The group consisted of 49 sisters. Patient satisfaction with care was assessed using the standardized patient satisfaction scale (PSS). The group consisted of 192 patients.

Results: The most omitted and inadequate nursing activities concerned the area of safe procedure for administration of enteral or parenteral nutrition, helping patients in eating, providing hygienic and skin care, wound treatment and adherence to aseptic procedures.

The most serious reasons for the delay or failure to provide nursing care were reported by nurses to have unplanned patients’ admissions and discharges the day, insufficient nursing staff, lack of support staff, and worsening of the patient’s condition. The nurses rated the work environment as favourable. The nurses evaluated the area of staffing and adequacy of resources as unfavourable working environment. Patient satisfaction with care was influenced only by the patient's health. Patients best rated the professionalism and behaviour of nurses. The most adverse events occurred in connection with non-compliance with aseptic procedures and medication errors. Health-related infections were most often related to peripheral vascular infections, surgical site infections and urinary tract infections.

Conclusion: The results of the survey serve to obtain the first information from the research in the Czech clinical environment and contribute to the initiation of a discussion on the issue and consequences of omitted-missing nursing care.

Keywords:

omitted-missing nursing care – nurses working environment – patient satisfaction – Adverse events – pilot study

Zdroje

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