Systems, economics, and neoliberal politics: Theories to understand missed nursing care

Jones, Terry; Drach‐Zahavy, Anat; Amorim‐Lopes, Mário; Willis, Eileen

doi:10.1111/nhs.12700

Cited by 23 publications

(26 citation statements)

References 44 publications

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“…Strategies reported at the hospital levels contribute to tackling the antecedents of MNC recently established at the macro level (Jones et al., 2020). First, NMs/NDs suggested the need to shape hospitals for: the size of the units—which might allow NMs to increase their control over the nursing practice; the internal flow processes—preventing the exposure of the patients to risks; and the external flow processes—limiting free access of family carers.…”

Section: Discussionmentioning

confidence: 99%

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Strategies to prevent missed nursing care: An international qualitative study based upon a positive deviance approach

et al. 2020

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Aim To identify the strategies to prevent missed nursing care (MNC) that can be implemented by nurse managers/directors on a daily basis. Background Only few recommendations have been established to date aiming at supporting nurse managers/ directors in preventing MNC. However, several strategies are implemented on a daily basis, suggesting that a body of tacit, practical and wise knowledge is already in place. Method(s) An international qualitative descriptive study based on the positive deviance approach conducted in 2019−2020 and reported according to the Consolidated Criteria for Reporting Qualitative Research. A purposeful sample of 35 nurse managers/directors working in hospitals in Cyprus, Italy, Germany and Switzerland was involved. Codes were extracted from each country, and a thematic analysis was performed at the transnational level to identify strategies and interventions preformed to prevent MNC. Results Eight strategies and 22 interventions, mainly with preventive intent and designed at the hospital level, affecting both the processes and the structural dimensions, have been reported as effective in preventing MNC. Conclusion Nurse leaders are involved daily in implementing strategies to minimise MNC at the nursing and at the hospital system levels, integrated with each other. Implications for Nursing Management Preventing MNC should be a core value of the entire hospital, and not merely a nursing issue. Therefore, complex interventions at the system level are required.

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Section: Discussionmentioning

confidence: 99%

“…Strategies reported at the hospital levels contribute to tackling the antecedents of MNC recently established at the macro level (Jones et al, 2020). First, NMs/NDs suggested the need to shape hospitals for:…”

Section: Strategies To Prevent Mncmentioning

confidence: 99%

Strategies to prevent missed nursing care: An international qualitative study based upon a positive deviance approach

et al. 2020

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“…Unfinished nursing care (UNC), (or other interchangeably used terms such as "implicit rationing", "missed nursing care", and "care left undone") is a global phenomenon in health care, negatively associated with patient safety culture, quality of nursing care and nurse-related outcomes, such as nurse retention and job satisfaction (Jones et al, 2019). The predicted worldwide nursing shortage emphasizes the urgent need to facilitate a better understanding of this phenomenon in the international professional nursing community (Gustafsson et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, there has been a growing body of research, over the last two decades, investigating the multifactorial nature of the phenomenon of UNC and cause-effect relationships with UNC, since they determine the type of interventions that can mitigate UNC events. Antecedents or contributing factors of UNC are defined and understood through influential; conceptual frameworks of UNC (Bail et al, 2020a;Jones et al, 2019). Predictors of, or contributing factors to UNC represent a complex mixture of nurse and patient characteristics, hospital and unit characteristics, organizational variables and attributes of NWE, and care philosophy that can negatively affect nurses' capacity to carry out care activities (Jones et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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

Gurková¹,

Bartoníčková²,

Mikšová³

2021

Cent Eur J Nurs Midw

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Aim: This scoping review aimed to summarize the evidence regarding the relationship between the nursing work environment and unfinished nursing care, and to offer a deeper insight into organizational factors of unfinished nursing care in hospital settings. A further aim of the study was to collate evidence about instruments for measurement of nurses' perceptions of the nursing work environment. Design: A scoping review was performed. Methods: A search was conducted in eight scientific databases. The final review included 22 studies and publications ranging from 2010 to 2020. Guidelines regarding scoping review methodology developed by the Joanna Briggs Institute were followed in our study. Results: The majority of studies included representative hospital and nurse samples, and had a cross-sectional design. Evidence indicates that the nursing work environment is a significant predictor of unfinished nursing care. The more favorable the nursing work environment, as perceived by nurses, the less frequently they reported unfinished nursing care events. The domains of the Practice Environment Scale of the Nursing Work Index were found to be significant predictors of unfinished nursing care. Conclusion: Nurses working in favorable conditions reported lower prevalence of unfinished nursing care. Improvements in staffing and resource adequacy were found to be the most significant factors predicting lower rates of unfinished nursing care. Refinement of factors in the nursing work environment and staffing are interventions that can mitigate unfinished nursing care. Further research should focus on the relationship between different dimensions of the nursing work environment and unfinished nursing care in hospital settings.

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“…social culture, ideologies and policies) that might affect the meso‐ and micro‐levels (e.g. routines and the habits) have also been highlighted (Jones et al, 2020). Therefore, external factors (e.g.…”

Section: Introductionmentioning

confidence: 99%

To what extent Unfinished Nursing Care tools coincide with the discrete elements of The Fundamentals of Care Framework? A comparative analysis based on a systematic review

Palese

Longhini

Danielis

2020

Journal of Clinical Nursing

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Aims and objectives To establish whether, and to what extent, tools measuring Unfinished Nursing Care (UNC) that have been validated to date have the ability to detect the discrete elements of the ‘Integration of care’ dimension of The Fundamentals of Care Framework (The Framework). Background UNC and The Framework have been established as two separate research lines, focused on (a) omitted care and related tools, and (b) on how to improve patient care, respectively. However, no attempts have been made to date to establish whether, and to what extent, tools measuring UNC have the ability to represent the discrete elements of The Framework. Design A two‐step study: (a) a secondary analysis of a systematic review up to June 2018 later updated in May 2020, followed by (b) a comparative analysis. Methods A systematic review of studies on validated tools measuring UNC was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. Then, researchers independently performed a comparative analysis between the extracted (a) discrete elements of The Framework and (b) items of the UNC tools retrieved. Results A total of 14 tools were analysed. The physical dimension of The Framework was the one mostly covered by UNC tools (up to 87.5% with the Perceived Implicit Rationing of Nursing Care). The Norwegian Basel Extent of Rationing of Nursing Care showed the highest level of representation (41.6%) for the psychosocial dimension. Only the Perceived Implicit Rationing of Nursing Care and the Unfinished Care tool measure the relational dimension (22.2%, respectively). By considering all elements of the ‘Integration of care’ dimension, the Perceived Implicit Rationing of Care had the highest percentage of convergence (41%). Conclusion Not all UNC tools have the same ability to represent the discrete elements of The Framework. Moreover, physical needs are more often detected in UNC tools compared to the relational and psychological ones. Relevance to clinical practice Unfinished care tools validated to date can represent a body of knowledge on which to build The Framework metrics, especially for the physical dimensions.

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Systems, economics, and neoliberal politics: Theories to understand missed nursing care

Cited by 23 publications

References 44 publications

Strategies to prevent missed nursing care: An international qualitative study based upon a positive deviance approach

Strategies to prevent missed nursing care: An international qualitative study based upon a positive deviance approach

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

To what extent Unfinished Nursing Care tools coincide with the discrete elements of The Fundamentals of Care Framework? A comparative analysis based on a systematic review

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