护理误时的普遍性及其与工作经验的关系:横断面调查

Hanne Mainz , Randi Tei , Karen Vestergaard Andersen , Marianne Lisby , Merete Gregersen
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引用次数: 0

摘要

背景医院中的护士面临着多种需求,常常不得不优先考虑护理工作。对护理遗漏的了解有助于深入了解是否提供了必要的护理、遗漏了哪些护理以及护理遗漏的原因。这种了解对于支持以证据为基础的政策和实践,以改善患者护理、提高护理实践和优化工作环境至关重要。要实施有针对性的策略,就必须对影响护理服务缺失的因素进行研究。然而,将工作经验作为预测因素的研究尚无定论,也未发现有研究探讨了护士的工作经验与护理服务缺失的不同因素之间的关系。目的探讨护理服务缺失的发生率和原因,以及护士的工作经验是否与护理服务缺失有关。研究在丹麦一家公立大学医院进行,该医院拥有 1150 张病床和大约 10,350 名员工。参与者在 34 个外科、内科和成人混合病床病房中,通过电子邮件邀请了 1,241 名护士匿名回答丹麦 MISSCARE 调查。结果超过三分之二的护士表示,情感支持、为病人洗澡、下床活动、口腔护理、跨学科会议、文件记录和药物疗效评估是经常被忽略的护理内容。造成护理遗漏的最主要原因是护士人数不足、病人数量意外增加、病人情况紧急、入院和出院活动频繁。结论避免潜在危急情况的护理要素和与治疗观察相关的护理很少被遗漏,而只有患者和护士可见的护理要素却最常被遗漏。通过提高护理工作的透明度和明确性,结果可以对护理要素的优先次序进行批判性评估。工作人员数量与病人数量和病情严重程度不平衡是造成护理遗漏的主要原因。经验不足的护士对护理遗漏的感知最为明显。该研究有助于全球研究界更广泛地了解护理遗漏问题。Tweetable 摘要主要是经验不足的护士认为,避免潜在危急情况和治疗观察优先于基本护理。
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Prevalence of missed nursing care and its association with work experience: A cross-sectional survey

Background

Nurses faced with multiple demands in hospitals are often compelled to prioritize nursing care. Knowledge of missed nursing care provides insight into whether necessary nursing care is delivered, what is missed, and the reasons for missed nursing care. This insight is essential to support evidence-based policy and practice to improve patient care, enhance nursing practice, and optimize the work environment. Research on factors influencing missed nursing care is imperative to implement targeted strategies. However, studies investigating work experience as a predictor are inconclusive, and no identified studies have examined how nurses’ work experience is associated with different elements of missed nursing care.

Objectives

To investigate the prevalence and reasons for missed nursing care and whether nurses' work experience was associated with missed nursing care.

Design

The design was cross‐sectional, using the Danish version of the MISSCARE survey.

Setting

The study was conducted at a public Danish university hospital with 1,150 beds and approximately 10,350 employees.

Participants

Across 34 surgical, medical, and mixed bed wards for adults, 1,241 nurses were invited by email to respond anonymously to the Danish MISSCARE survey. Of these nurses, 50.3% responded, and 42.6% fully completed the questionnaire.

Methods

A total score mean and a mean score were calculated and then compared between experience (≤5 years/>5 years) in a linear regression model adjusting for unequally distributed variables.

Results

More than two thirds of the nurses reported that emotional support, patient bathing, ambulation, mouth care, interdisciplinary conferences, documentation, and assessing effectiveness of medication were frequently missed elements of nursing care. The most significant reasons for missed nursing care were an inadequate number of nurses, an unexpected rise in patient volume, urgent patient situations, heavy admission, and discharge activity. Nurses with work experience of less than 5 years reported more missed nursing care, especially within fundamental care.

Conclusions

Nursing elements to avoid potentially critical situations and nursing related to treatment observations were rarely missed, while nursing care elements visible only to the patient and the nurse were most often missed. By increasing transparency and explicitness within nursing care, the results enable critical evaluation of prioritization of nursing care elements. The number of staff not balancing the number and acuity of patients was the main reason for missed nursing care. The perception of missed nursing care was most pronounced in less experienced nurses. The study contributes to the global research community to achieve a broader understanding of missed nursing care.

Tweetable abstract

Nursing to avoid potentially critical situations and treatment observations are prioritized over fundamental care, perceived mainly by less experienced nurses.

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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
45
审稿时长
81 days
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