Jane E Ball1,2, Peter Griffiths3, Anne Marie Rafferty4, Rikard Lindqvist2, Trevor Murrells4, Carol Tishelman5. 1. National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, Southampton, UK. 2. Medical Management Centre (MMC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet (KI), Stockholm, Sweden. 3. University of Southampton & NIHR CLAHRC, Wessex, UK. 4. Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK. 5. KI MMC, LIME KI & Innovation Centre, Karolinska University Hospital, Stockholm, Sweden.
Abstract
AIMS: To determine factors associated with variation in 'care left undone' (also referred to as 'missed care') by Registered Nurses (RNs) in acute hospital wards in Sweden. BACKGROUND: 'Care left undone' has been examined as a factor mediating the relationship between nurse staffing and patient outcomes. The context has not previously been explored to determine what other factors are associated with variation in 'care left undone' by RNs. DESIGN: Cross-sectional survey to explore the association of RN staffing and contextual factors such as time of shift, nursing role and patient acuity/dependency on 'care left undone' was examined using multi-level logistic regression. METHODS: A survey of 10,174 RNs working on general medical and surgical wards in 79 acute care hospitals in Sweden (January-March 2010). RESULTS: Seventy-four per cent of nurses reported some care was left undone on their last shift. The time of shift, patient mix, nurses' role, practice environment and staffing have a significant relationship with care left undone. The odds of care being left undone is halved on shifts where RN care for six patients or fewer compared with shifts where they care for 10 or more. CONCLUSION: The previously observed relationship between RN staffing and care left undone is confirmed. Reports of care left undone are influenced by RN roles. Support worker staffing has little effect. Research is needed to identify how these factors relate to one another and whether care left undone is a predictor of adverse patient outcomes.
AIMS: To determine factors associated with variation in 'care left undone' (also referred to as 'missed care') by Registered Nurses (RNs) in acute hospital wards in Sweden. BACKGROUND: 'Care left undone' has been examined as a factor mediating the relationship between nurse staffing and patient outcomes. The context has not previously been explored to determine what other factors are associated with variation in 'care left undone' by RNs. DESIGN: Cross-sectional survey to explore the association of RN staffing and contextual factors such as time of shift, nursing role and patient acuity/dependency on 'care left undone' was examined using multi-level logistic regression. METHODS: A survey of 10,174 RNs working on general medical and surgical wards in 79 acute care hospitals in Sweden (January-March 2010). RESULTS: Seventy-four per cent of nurses reported some care was left undone on their last shift. The time of shift, patient mix, nurses' role, practice environment and staffing have a significant relationship with care left undone. The odds of care being left undone is halved on shifts where RN care for six patients or fewer compared with shifts where they care for 10 or more. CONCLUSION: The previously observed relationship between RN staffing and care left undone is confirmed. Reports of care left undone are influenced by RN roles. Support worker staffing has little effect. Research is needed to identify how these factors relate to one another and whether care left undone is a predictor of adverse patient outcomes.
Authors: Nele Van Damme; Karen Van den Bussche; Dorien De Meyer; Ann Van Hecke; Sofie Verhaeghe; Dimitri Beeckman Journal: Int Wound J Date: 2016-12-09 Impact factor: 3.315
Authors: Shira G Winter; Ann P Bartel; Pamela B de Cordova; Jack Needleman; Susan K Schmitt; Patricia W Stone; Ciaran S Phibbs Journal: Health Serv Res Date: 2021-09-02 Impact factor: 3.402
Authors: Peter Griffiths; Alejandra Recio-Saucedo; Chiara Dall'Ora; Jim Briggs; Antonello Maruotti; Paul Meredith; Gary B Smith; Jane Ball Journal: J Adv Nurs Date: 2018-04-23 Impact factor: 3.187
Authors: Claire Pentecost; Julia Frost; Holly V R Sugg; Angelique Hilli; Victoria A Goodwin; David A Richards Journal: J Clin Nurs Date: 2019-11-19 Impact factor: 3.036