Missed nursing care in a long-term rehabilitation setting: findings from a cross-sectional study

: Background: There is a growing amount of literature that links missed nursing care (MNC) to negative patient outcomes, reduced patient safety and poor quality of care. However, only few studies have investigated this phenomenon in long-term rehabilitation settings.Aim: To explore MNC occurrence, type, reasons and predictors in three rehabilitation units.Design: A cross-sectional study was performed between August and September 2017.Method: 95 registered nurses and nursing assistants completed section A (interventions missed) and section B (perceived reasons for MNC) of the MISSCARE Survey tool. Descriptive, bivariate and linear regression analyses were performed.Findings: The top missed elements were patient ambulation (score 2.4 out of 5, Standard Deviation [SD] 0.8), mouth care (2.3, SD 0.8) and participation to multidisciplinary meetings (2.3, SD 1.1). Lack of personnel was the most frequent reason reported for MNC with a score of 2.9 out of 4 (SD 0.9). At the linear regression analysis, advanced nursing education (β = 3.58, CI 95% 1.32-5.84) and inadequate handovers (β = 3.64, CI 95% 0.37-6.91) both increased the perception of MNC occurrence.Conclusion: MNC occurrence in rehabilitation settings appears to be lower than in other contexts; however, the most commonly missed elements are similar to those reported in other settings. As good strategies to detect the difference between expected nursing care and the one delivered to patients, advanced education and good quality handovers seem beneficial. Further research is needed to establish more evidence on predictors by developing longitudinal study designs

Guida operativa per la riprogettazione delle consegne tra turni

Pratical guide to improve the quality of nursing handovers between shifts. In recent years, the interest on nursing handover has increased both professionally and scientifically. Many hospitals and health care institutions have designed and implemented educational strategies and specific projects with the intent to improve the quality of nursing handovers. However, no practical guides on handovers capable of supporting both the daily practice and the improvement processes have been published to date. Moreover, the emphasis of the publications available to date has been mainly on how to give information during the handover's processes while its overall aspects, as those connected to cognitive, social and cultural processes of the team, have been mainly neglected. With the intent to fill in the gap, we have identified and summarised a series of practical indications for those who wish to improve the quality and/or to critical reflect on handovers, by integrating with the available literature the knowledge derived from daily practice

Interventi attuati da infermieri con ruoli manageriali nella pratica quotidiana per prevenire e minimizzare le Missed Nursing Care: risultati di uno studio qualitativo italiano [Effective interventions enacted by Nurse Managers in daily practice to prevent and/or minimize the missed nursing care: findings from an Italian qualitative study]

Missed Nursing Care is widely recognized as affecting patient safety and healthcare outcomes. Theoretical frameworks, antecedents and consequences have been extensively studied while interventions aimed at preventing the Missed Nursing Care remain little investigated to date. Nurse Managers and Nurse Directors play a main role in promoting interventions at the unit, hospital and at the policy levels. However, few evidences are available to date, thus limiting an evidence-based approach. The aim of this study was to emerge interventions used on a daily basis by Nurse Managers and Directors to prevent and/or minimize Missed Nursing Care

Developing Policies and Actions in Response to Missed Nursing Care: A Consensus Process

16siAIM: To support the development of appropriate policies and actions in the field of Missed Nursing Care (MNC). BACKGROUND: There has been an ever-growing international debate on MNC, interventions that nurses have identified as necessary for their patients, but which for various reasons they are unable to provide or are forced to delay. Despite MNC's relevance, its translation into policies and actions has not been documented to date. METHOD: A Consensus Development Method was employed involving (1) a Nominal Group composed of experts in the field, policymakers, and the President of the Regional Nursing Professional Boards, and (2) 218 nurses appointed primarily at the managerial levels. RESULTS: A total of eight Consensus Statements were approved and organised in a series of sub-statements designed to: (1) Render the concept of MNC culturally acceptable in the Italian context, with the agreement that Compromised Nursing Care (CNC) is the best term to be used in this field, as a synonym for MNC; (2) Measure CNC as a strategy to increase patient safety; (3) Select an appropriate CNC measurement tool; (4) Optimise CNC measurement; (5) Conduct effective CNC data analysis; (6) Design and implement interventions to prevent and/or minimise CNC; (7) Assess and disseminate findings on interventions' effectiveness, and (8) provide final remarks on the way to move forward. CONCLUSIONS: We developed a process to introduce the phenomenon of MNC in the Italian culture and agreed firstly on the term Compromised Nursing Care, which better reflects MNC's meaning according to the context, and facilitates an open discussion on the phenomenon both within and outside the profession. The following Consensus Statements emerged represent a systematic approach, starting from the measurement and finishing with the re-measurement of the occurrence of MNC after having implemented concrete actions. IMPLICATIONS FOR NURSING MANAGEMENT: The approved Consensus Statements can guide decision-makers to develop concrete policies and actions that promote the improvement of quality of care and patients' safety by minimising and/or preventing MNC's occurrence.partially_openembargoed_20200726Palese, Alvisa; Bassi, Erika; Tommasini, Cristina; Vesca, Roberta; Di Falco, Achille; De Lucia, Paola; Mulloni, Giovanna; Paoletti, Flavio; Rissolo, Raffaela; Sist, Luisa; Sanson, Gianfranco; Guardini, Ilario; Bressan, Valentina; Mesaglio, Maura; Papastavrou, Evridiki; Blackman, IanPalese, Alvisa; Bassi, Erika; Tommasini, Cristina; Vesca, Roberta; Di Falco, Achille; De Lucia, Paola; Mulloni, Giovanna; Paoletti, Flavio; Rissolo, Raffaela; Sist, Luisa; Sanson, Gianfranco; Guardini, Ilario; Bressan, Valentina; Mesaglio, Maura; Papastavrou, Evridiki; Blackman, Ia

Missed nursing care e pratica infermieristica italiana: risultati preliminari di una consensus conference

Negli ultimi anni \ue8 emerso un crescente interesse per le missed nursing care anche nel contesto italiano grazie a diversi fattori tra i quali la partecipazione al progetto RANCARE insieme a 28 paesi Europei e non, l\u2019opportunit\ue0 di organizzare scambi internazionali, di condurre revisioni sistematiche e progetti di ricerca specifici nel campo. Per affrontare questioni metodologiche specifiche emerse via via nel nostro percorso di ricerca e diffusione dei risultati sulle missed nursing care nella pratica italiana, abbiamo organizzato una consensus conference dopo aver realizzato una revisione preliminare della letteratura sul concetto e sulle propriet\ue0 psicometriche delle scale disponibili per migliorare la conoscenza del concetto di missed nursing care, le sue implicazioni per la pratica, il management, la formazione e la ricerca. Alla fine della conferenza, durata due giorni, oltre 200 infermieri partecipanti hanno approvato una serie di raccomandazioni sulle missed nursing care e la pratica infermieristica italiana. Questo documento riporta i risultati preliminari del consenso raggiunto

Progetto di Ricerca LARS (Laboratorio di Ricerca Infermieristica Agenzia Regionale alla Sanità, Friuli Venezia Giulia). Studio osservazionale sugli esiti dei modelli organizzativi assistenziali delle medicine, su infermieri, su pazienti ed organizzazione.

No large scale studies have been conducted in Italy to assess factors that influence hospital nurses’ satisfaction. Aims. To explore the relationship between participative organizative models and outcomes on nurses (work satisfaction, burnout, intention to stay), patients (satisfaction with quality of care) and organization (nurses turnover). Materials and methods. This multicentre regional study involves 20 acute medical wards and more than 500 nurses. Data on the organizative model adopted in the ward will be collected with an ad hoc questionnaire with scores from 7 (scarcelimited involvement of nurses in decision making) to 35 (nurses take decisions on the management of the ward). Nurses satisfaction with their work is measured with the Nursing Work Index Revised; burnout with the Maslack Burnout Inventory; patients satisfaction with the Experiences of Nursing Care Scale Newcastle Satisfaction with Nursing Scale. The outcomes considered for the organization will be turnover, absences from work, injuries. Resultats. The study is ongoing. The association of each outcome to the organizzative model will be explored. Multivariate regression model will be adjusted for casemix index of the previuos year. T test and chi square tests will be used and a p value of 0.05 will be considered significant