06 febuary, 2014
This study was done to examine various types of nursing care that are regularly missed at the medical-surgical units and those reasons why such types of nursing care are missed. We need to understand the fact that nursing care for patients is an essential key in managing patients, in the hospital. Understanding the goal of the study is a step towards creating the needed help to make a change in nursing care. Literature review shows that there is a lack of studies in relations to nursing care missed identified hence those elements are separated while explored. The research questions of this study are in two different sets. The nursing care missed in both the surgical-medical units and the special reasons the nurses have identified to be the major causes of such misses.
The findings from this study are based on the nine elements of regularly missed nursing care. Those elements are ambulation, turning, delayed or missed feedings, patient teaching, discharge planning, emotional support, hygiene, intake and output documentation, and surveillance. The qualitative study focused on two different hospitals with 107 registered nurses (RNs), 15 licensed practical nurses (LPNs) and 51 nursing assistants (NAs). Data collection was done in the form of focus groups with those groups being interviewed and findings recorded in an audio. The recorded findings were analyzed, and transcribed, for better results. Grounded theory approach with qualitative analysis software was used in the analysis.
Study findings of this research focuses more on the nine types of ‘missed nursing care’. Interview was done by asking the members if those misses are on the regular basis on not. Those nurses were informed as regards to goals of the research and the reasons for embarking on the project. Those members selected as the member of the project group are those that gave the information. The nurses are also informed as regards to the confidentiality of the information they provided.
Several reasons are stated to contribute to the factor responsible missed care. Most of that missed care are secondary to the few nursing staffs, poor use of existing staff capability, and ‘it is not my job syndrome’. Others are due to reasons such as the ineffective delegation, habit and denial. Some of the situations noted to create the short staffing influencing the missed care for patients are the inadequate staff-to-patient ratio, absence of staff, unexpected heavy work demands or loads.
Those findings have shown those important nursing care that are element of patients care in terms of patient point of health delivery. That noted missed care is found to contribute to the poor patient outcomes. Any of those missed care may be found to contribute to any disease state. For instance, inadequate feeding of patients that are under medications will directly or indirectly contribute to the rate of healing or recovery of the patients. There is an important notion regarding the use and information gathered from the study.
It is important to note that some of the missed care or the study will contribute to the nursing practice if taking seriously in terms of trying to solve the problems identified in the study. For instance, if a hospital that has a shortage of nursing staff is being focused on in terms of employing more staffs, such hospital or clinic will definitely experience positive changes where there are previous shortcomings. This increased staffing ratio among the nursing staffs will help reduce the missed care rate in the hospital. Other factors identified to contribute to the missed care will also be affected by the changes in the staff ratio. This is simply in terms of the fact that the other factors responsible for the missed care will be affected by those other factors.
This study suggests some forms of implication as regards to the nursing staffs and managers. The good thing about the implication of the study to the nursing practice from the research perspective is that it can actually help to identify a problem and then proffer the required solution to the problem. This will subsequently contribute to the development of the profession. It will contribute to the development in terms of the staff delegation to required job, training and their performances.
It will also allow substantial follow up to be done for each of the missed care noted to be related to the staff practice. As regards to the ethical and professional aspect of the project, there is a limitation to findings of the study. This is simply in terms of the population study which was only taken from two hospitals. More studies needed to be done to be able to identify the validity these findings. Other study approach will also need to be used to be able to determine the relationship and the validity of the results of this study.
In terms of the ethical consideration relating to this paper, what needed to be considered relates more to the aspect of the confidentiality of the information provided by the members of the focus groups. The information provided during this research study is very vital and needs to be taken as a private entity.
Work Cited
Kalisch, B.J. Missed nursing care: a qualitative study. J Nurs Care Qual. 2006 Oct-Dec;21(4):306-13
