Perspectives of Oncology Unit Nurse Managers on Missed Nursing Care: A Qualitative Study

Abstract Background Frail older adults who are hospitalized, are more likely to experience missed nursing care (MNC) due to high care needs, communication problems, and complexity of nursing care. We conducted a qualitative study to examine the factors affecting MNC among hospitalized frail older adults in the medical units. Methods This qualitative study was carried using the conventional content analysis approach in three teaching hospitals. Semi-structured interviews were conducted with 17 nurses through purposive and snowball sampling. The inclusion criteria for the nurses were: at least two years of clinical work experience on a medical ward, caring for frail older people in hospital and willingness to participate. Data were analyzed in accordance with the process described by Graneheim and Lundman. In addition, trustworthiness of the study was assessed using the criteria proposed by Lincoln and Guba. Results In general, 20 interviews were conducted with nurses. A total of 1320 primary codes were extracted, which were classified into two main categories: MNC aggravating and moderating factors. Factors such as “age-unfriendly structure,” “inefficient care,” and “frailty of older adults” could increase the risk of MNC. In addition, factors such as “support capabilities” and “ethical and legal requirements” will moderate MNC. Conclusions Hospitalized frail older adults are more at risk of MNC due to high care needs, communication problems, and nursing care complexity. Nursing managers can take practical steps to improve the quality of care by addressing the aggravating and moderating factors of MNC. In addition, nurses with a humanistic perspective who understand the multidimensional problems of frail older adults and pay attention to their weakness in expressing needs, can create a better experience for them in the hospital and improve patient safety.

Download Full-text

Missed nursing care and complexity theory: a conceptual paper

Journal of Research in Nursing ◽

10.1177/17449871211013073 ◽

2021 ◽

pp. 174498712110130

Author(s):

Rania Ali Albsoul ◽

Gerard FitzGerald ◽

James A Hughes ◽

Muhammad Ahmed Alshyyab

Keyword(s):

Complexity Theory ◽

Nursing Care ◽

Complex Adaptive Systems ◽

Adaptive Systems ◽

Nurse Managers ◽

Systems Approach ◽

Complex Adaptive ◽

Missed Care ◽

Missed Nursing Care ◽

The Impact

Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.

Download Full-text

Decision letter for "The nurse’s experience of decision-making processes in missed nursing care: A qualitative study"

10.1111/jan.14387/v2/decision1 ◽

2020 ◽

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Nursing Care ◽

Decision Making Processes ◽

Missed Nursing Care

Download Full-text

Review for "The nurse’s experience of decision-making processes in missed nursing care: A qualitative study"

10.1111/jan.14387/v1/review1 ◽

2019 ◽

Keyword(s):

Decision Making ◽

Qualitative Study ◽

Nursing Care ◽

Decision Making Processes ◽

Missed Nursing Care

Download Full-text

Nurses' efforts to maintain competence: a qualitative study

Journal of Public Health Research ◽

10.4081/jphr.2021.2736 ◽

2021 ◽

Author(s):

Nur Miladiyah Rahmah ◽

Tutik Sri Hariyati ◽

Junaiti Sahar

Keyword(s):

Nursing Care ◽

Clinical Competence ◽

Nurse Managers ◽

Continuing Professional Development ◽

Nursing Services ◽

Ensure Patient Safety ◽

Missed Care ◽

Qualitative Phenomenological ◽

Missed Nursing Care ◽

Competence System

Background: The clinical competence of nurses should be maintained to ensure patient safety. Competence is the integration of knowledge, skills, and attitudes. Nurse competency also improves the quality of nursing care and reduces the incidence of missed nursing care. This study aimed to explore the experiences of nurses maintaining a nurse competence system in hospitals through continuing education.Design and Methods: The research method used was qualitative phenomenological research, and the data was collected through an in-depth interview which was consist of six participants.Results: The results of the research were 1). continuing professional development to maintain the competence, 2) credentialing system in the career ladder system, 3). missed care still occurred in the implementation of nursing services 4). Nurses had hopes that managers supported the efforts to maintain competence through continuing professional development.Conclusion: Nurse managers are expected to improve the supervision program to maintain clinical competence and decrease missed care.

Download Full-text