Good practices to reduce unfinished nursing care: An integrative review

Abstract

Recent nursing investigations highlight that patient safety is compromised by unfinished nursing care. Unfinished nursing care can be described as an error of omission because the totality, or just part, of the care needed by the patient was not provided essentially due to time scarcity (Kalisch, Landstrom, & Hinshaw, 2009). As a result, nurses prioritize the essential care they need to provide to their patients, which may then lead to unfinished nursing care (Jones, Hamilton, & Murry, 2015). There is no consensus on which is the best terminology to define unfinished care. In literature, we may find expressions such as 'missed nursing care,' 'unfinished care,' 'care

Hospital and unit variables of missed nursing care in acute care hospitals: A cross‐sectional study

“…Missed nursing care (and other related and interchangeably used terms such as implicit rationing, unfinished nursing care, care left undone, unmet nursing care needs or failure to maintain) has, in the last decade, begun to be considered a global, multifactorial and complex socio‐economic problem (Jones et al, 2019). It results from limited nursing resources or a variety of organisational constraints in the healthcare sector, predominantly, the lack of nursing human resources (Cordeiro et al, 2020). The common denominator of missed nursing care (MNC) is the problem of resource scarcity, in particular, lack of time (Jones et al, 2019) and multiple demands (Kalisch et al, 2009; Liu et al, 2018), facilitating a process of implicit rationing of care (Schubert et al, 2007) through which nurses decide which interventions they are able or unable to provide, or are forced to delay (Palese et al, 2019).…”

Nursing work environment and unfinished nursing care in hospital settings - a scoping review

“…Park et al (2018) identified three domains (staffing and resource adequacy; nursephysician relations; and nurse participation in hospital affairs) that were significantly related to UNC. Recent research syntheses (Cordeiro et al, 2020;Zhao et al, 2020) have emphasized that there is a continuing need to explore the potential differential impact of dimensions of the NWE on UNC events. Almost all included studies had a cross-sectional design that did not allow causal inferences.…”

“…NWE characteristics were confirmed in recent research syntheses (Griffiths et al, 2020;Jones et al, 2015) as a stronger predictor of UNC than individual nurse variables (such as gender, age, education, experience, work role etc.). Current research syntheses (Cordeiro et al, 2020;Griffiths et al, 2020;Jones et al, 2015;Papastavrou et al, 2014a;Zhao et al, 2020) have identified two common organizational determinants of UNCthe NWE and staffing. Moreover, these reviews have discussed how supportive work environments with increased teamwork and effective communication between all health professionals, and adequate staffing are linked to lower UNC (Cordeiro et al, 2020;Zhao et al, 2020;Lake et al, 2020b).…”

“…Current research syntheses (Cordeiro et al, 2020;Griffiths et al, 2020;Jones et al, 2015;Papastavrou et al, 2014a;Zhao et al, 2020) have identified two common organizational determinants of UNCthe NWE and staffing. Moreover, these reviews have discussed how supportive work environments with increased teamwork and effective communication between all health professionals, and adequate staffing are linked to lower UNC (Cordeiro et al, 2020;Zhao et al, 2020;Lake et al, 2020b). However, Zhao et al (2020) have argued that previous empirical studies and syntheses failed to systematically explore the association between specific domains of the nursing work environment and UNC.…”

Strategies for Reducing Rationed Nursing Care: Qualitative Secondary Analysis

“…Most of them have focused on investigating factors contributing to rationed nursing care with the aim to plan effective strategies focusing on its reduction or elimination from the clinical setting (1,7). Nowadays, several strategies have been developed yet, such as adequacy of human resources, nurse-to-patient ratio, workload distribution, improvement of the working environment with increased teamwork and effective communication among all health professionals (8). Furthemore, Longhini et al (9) identified eight strategies focusing on nursing care capacity, nurses´ performance, active engagement of nurses in rationed nursing care issues, nursing documentation, contrasting predictable issues, the system for detecting and managing risks, communication and collaboration, and the role of nurse leaders.…”