Every day, nurses are expected to make decisions on how to prioritize their interventions by considering, on the one hand, patients' needs and those of their carers, while on the other hand, the resources available in the specific context. This decisional process is the antecedent of tasks left undone (Aiken et al., 2001), missed nursing care (Kalisch, Landstrom, & Hinshaw, 2009) or the rationing of nursing
Background Contrary to Missed Nursing Care, some anecdotal data and sparse evidence has documented the tendency of nurses to anticipate some nursing interventions. However, no study has been conducted to date with the purpose of understanding this phenomenon and its underlying mechanisms and consequences. The aim of this study was to describe the phenomenon of delivering anticipated nursing care, its antecedents and consequences as perceived by nurses. Method A descriptive qualitative study. The Consolidated Criteria for Reporting Qualitative Research guidelines were followed. A purposeful sample of 17 clinical nurses and nurse managers working in three Italian hospitals were interviewed in depth in 2019. The audio-recorded interviews were verbatim transcribed and thematically analysed. Results ‘Anticipated Nursing Care’ is delivered significantly earlier than when expected by nurses in their care plan, by patients, by caregivers and by other members of the team. Medication administration, mobilisation of patients, hygiene care, changes of dressing, vital parameter monitoring, blood sampling and administrative activities were reported as interventions delivered before rather than when expected. Clinically stable patients have been reported to be at risk of receiving anticipated nursing care. Individual values and attitudes, group attitudes of being always ready for the “unexpected”, implicit group norms to “leave the patients and the unit in order”, high workloads, intertwined activities and work processes inside the units, have been reported as reasons for Anticipated Nursing Care. Effects of this phenomenon have been reported at the patients’ and at the nurses’ level. Conclusion Anticipated Nursing Care occurs when nurses perform interventions earlier than expected according to an implicit or explicit decision and not as a consequence of a request. The phenomenon requires future studies to detect its diffusion and to accumulate evidence. Its presence in daily practice, if confirmed, suggests that Missed Nursing Care studies should also consider the combined effect of these two phenomena as, on one hand, there may be the tendency to postpone and, on the other hand, the tendency to anticipate interventions.
During their clinical rotations, nursing students are exposed to real situations, and, alongside good examples of clinical practice, they might also witness examples of poor practice that may threaten patient safety (Ion et al., 2015). Among several experienced nursing practices, missed nursing care (MNC), or any aspect of required nursing care that is omitted (in part or in whole) or delayed (Kalisch, 2006) -also known as care left undone, rationing of nursing care and unfinished nursing care (Bassi et al., 2018) -which leads to negative outcomes (Jones et al., 2019) might be witnessed by nursing students.As documented, students have developed a progressive awareness that MNC exists as an expression of the gap between theory and practice (Greenway et al., 2019). It has also been reported that students have learned that no nurse would intentionally miss nursing care, but sometimes this can happen due to many competitive interventions and priorities (Gibbon & Crane, 2018). In witnessing MNC episodes, students experienced a cognitive dissonance threatening their professional and personal values (Bagnasco et al., 2017) and felt negative emotions (Gibbon & Crane, 2018).At the same time, however, nursing students struggle to express criticism because this can affect their internship evaluations (Ion
ObjectivesTo evaluate the methodological quality of randomised controlled trial (RCT) abstracts in leading critical care nursing journals against the Consolidated Standards of Reporting Trials-Abstracts (CONSORT-A) checklist and to identify variables related with abstract reporting quality.DesignDescriptive methodological quality review.Data sourceWe searched the PubMed database and the websites of each included journal.Eligibility criteriaWe included RCT abstracts published between 2011 and 2021 in the first 11 Scopus-ranking (2021) critical care nursing journals that reported the results of RCTs in English that referred to the care of adult patients with acute/critical illness or their relatives and/or caregivers and conducted in ICUs.Data extraction and synthesisTwo independent investigators extracted the data using a prespecified 17-item checklist directly derived from CONSORT-A. For the primary outcome, each item was evaluated whether it was adequately reported or not and descriptive statistics were reported. An overall score was calculated by summing the results of all items and multivariate linear regression was conducted to detect potential predictors.ResultsSeventy-eight RCT abstracts were included in this review. The items with the highest CONSORT-A adherence were authors, objective, conclusion, participants, interventions and outcome. The randomisation item had the lowest CONSORT-A adherence, followed by trial registration, funding source, harms or side effects, recruitment, blinding and outcome results. The average CONSORT-A score was 8.5±1.5 points (of the maximum 17.5 points). Multivariate analysis indicated that the categorised word score and publication date were positively associated with the overall CONSORT-A score, while the first author’s country being in Asia was negatively associated with the overall CONSORT-A score.ConclusionsThe 78 RCT abstracts showed poor overall adherence to CONSORT-A. The results indicate that the methodological reporting quality of RCT abstracts in critical care nursing journals requires improvement to facilitate assessment of the applicability and relevance of the results reported.
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