Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study (original) (raw)
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Medical care research and review : MCRR, 2015
This study integrates previously isolated findings of nursing outcomes research into an explanatory framework in which care left undone and nurse education levels are of key importance. A moderated mediation analysis of survey data from 11,549 patients and 10,733 nurses in 217 hospitals in eight European countries shows that patient care experience is better in hospitals with better nurse staffing and a more favorable work environment in which less clinical care is left undone. Clinical care left undone is a mediator in this relationship. Clinical care is left undone less frequently in hospitals with better nurse staffing and more favorable nurse work environments, and in which nurses work less overtime and are more experienced. Higher proportions of nurses with a bachelor's degree reduce the effect of worse nurse staffing on more clinical care left undone.
Unfinished nursing care in four central European countries
Journal of Nursing Management, 2019
Aim: The main aim of the research was to describe and compare unfinished nursing care in selected European countries. Background: The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities. Methods: A cross-sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia). Results: The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care. Conclusion: The research results confirmed the prevalence of unfinished nursing care in the countries surveyed. Implications for Nursing Management: The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care.
RN4Cast Study in Portugal: Nurses and care left undone
Journal of Hospital Administration, 2018
Background: Over the past decades, nursing in Portugal has evolved greatly both academically and professionally and this evolution brought along growing concerns about the quality of the healthcare provided. Due to lack of time or poor organization of the workload, nurses are often faced with the need to choose between what must be done and what will have to be postponed or even not be done at all.Objective: To investigate the care activities that are most frequently left undone or are postponed by nurses working in medical and surgical inpatient units in Portugal.Methods: A descriptive, cross-sectional, quantitative study that follows the RN4CAST (Nurse Forecasting in Europe) methodology was carried out from October 2013 to April 2014. A total of 31 hospitals and a random sample of adult medical-surgical units were involved. The data were collected using a socio-demographic questionnaire and a nursing questionnaire that included the identification of the nursing activities of surve...
Background The shortage of health workers is a global phenomenon. To meet increasing patient demands on UK health services, providers are increasingly relying on temporary staff to fill permanent posts. This study examines the occurrence of ‘care left undone’, understaffing and temporary staffing across acute sector settings. Methods Staffing and ‘care left undone’ measures were derived from the responses of 13, 218 registered nurses across the UK. A locally smoothed scatterplot smoothing regression analysis (Loess) was used to model the relationship between any ‘care left undone’ events and full complement, modest and severely understaffed shifts, and proportions of temporary staff. Results Occurrence of ‘care left undone’ was highest in Emergency Departments and lowest in Theatre settings. The odds of ‘care left undone’ increase with increasing proportion of temporary staff. This trend is the same in all understaffing categories. On shifts with a full quota of nursing staff, an in...
What impact does nursing care left undone have on patient outcomes? Review of the literature
Journal of clinical nursing, 2017
Systematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes. A considerable body of evidence support the hypothesis that lower levels of registered nurses on duty increases the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear. Systematic review. We searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses' aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review. Fourteen studies reported associations between missed care and patient outco...
Unfinished nursing care - the first pilot study in the Czech Republic
Kontakt, 2019
Aim: The main aim of this pilot study was to investigate the amount, type and reasons for unfinished nursing care among Czech hospital nurses. The other aim was to compare the differences in the level of unfinished nursing care according to age, perceived lack of staffing and job satisfaction of nurses. Design: A descriptive cross-sectional study. Methods: A self-reported PIRNCA (Perceived Implicit Rationing of Nursing Care) instrument was used to measure unfinished nursing care. A sample included 100 hospital bedside nurses from two different hospitals in the Moravian-Silesian Region, Czech Republic. Data were collected in 2017. Results: Elements of care most frequently left unfinished were: Timely response to patient/family request, Provide adequate supervision, Emotional or psychological support, Monitoring a patient's behavior, and Reviewing multidisciplinary patient documentation. Nurses reported the most common reasons for unfinished nursing care to be: inadequate number of nursing staff. The most differences in the level of unfinished nursing care were found to be dependent on perceived lack of staffing. Conclusions: This pilot study also revealed the existence of hidden phenomenon in Czech clinical practice. According to the results of this pilot study there are differences in the level of unfinished nursing care according to age, perceived lack of staffing and job satisfaction of nurses.