Examining missed care in community nursing: A cross section survey design

Abstract

The results of the study indicate a high prevalence of missed care in the community nurses surveyed and that preventative care was the type of care most likely to be missed. This has serious implications for a nursing service that is preventative in nature and suggests that the missed care framework could benefit workforce planning for community nursing services both in Ireland and elsewhere. Accordingly, policy, practice and educational reforms are fundamental to meet current and future population needs.

Double Jeopardy – Missed care for the vulnerable in community settings

“…Thus, community‐based nursing care has the potential to be an economical way to improve healthcare access and reduce health inequalities. At the same time, it remains unsystematic with some services “developed in an ad‐hoc manner….chronically under‐resourced and overburdened” (Phelan et al., : 627). Paradoxically community care resources have great potential contribution to not only improving inequities, but to improving health care in general, and are yet not sufficiently developed or resourced (Phelan et al., ).…”

“…At the same time, it remains unsystematic with some services “developed in an ad‐hoc manner….chronically under‐resourced and overburdened” (Phelan et al., : 627). Paradoxically community care resources have great potential contribution to not only improving inequities, but to improving health care in general, and are yet not sufficiently developed or resourced (Phelan et al., ). Conditions in the community setting in Italy are similarly challenging, with poor community nursing infrastructure and chronic staffing shortages (EFN, ), despite being a high‐income country.…”

“…Phelan et al. () drew our attention to the fact that while there has international focus on missed care, very little attention has been paid to exploring, conceptualising or measuring missed care in community settings. Using a cross‐sectional survey of nursing in Ireland, based on the internationally validated MISSCARE survey (Kalisch & Williams, ).…”

“…Phelan et al. () not only identified high levels of missed care, but also that disadvantaged groups were particularly underserved in this regard. There were high levels of missed care reported across eight specific items including health promotion, care management, disadvantaged groups, older people and administration (Phelan et al., ).…”

“…More than half of the relevant staff missed one key child health check (required at 3–4.5 years) (Phelan et al., ). More than 70% of the nurses reported missing routine care for vulnerable populations within their caseload (e.g., homeless people or migrants), but is also clear that both older people and children, also considered vulnerable groups, missed out on key care (Phelan et al., ). However, up until now there has been very little focus on missed care in older populations (Zúñiga et al., ).…”