Unfinished nursing care as indicator of adverse events in hospitalized patients

Marcela Babická ^*, Zuzana Slezáková
Slovak Medical University in Bratislava, Faculty of Nursing and Professional Health Studies, Bratislava, Slovak Republic

Korespondenční autor: Marcela Babická (marcelaxbabicka@gmail.com)

ISSN 1804-7181 (On-line)

Full verze:

Submitted:18. 3. 2024
Accepted: 28. 6. 2024
Published online: 30. 6. 2024

Summary

Introduction: The collective term ‘unfinished care’ refers to the factor of impact on the safety of health care. Nurses prioritise certain activities, leaving others unfinished. The risk of patient harm increases. Goal: Identify the relationships between unfinished nursing actions and adverse events.

Design: A descriptive cross-sectional study.

Methods: The research sample was formed by 251 nurses from the clinics of the University Hospital in Prague. The PIRNCA self-assessment instrument was used. Data collection and processing took place in 2022. Results: Significant differences were found in all areas of assistance in terms of the incidence of adverse events. Significant differences existed for walking (p = 0.005), mobilisation and positioning (p = 0.003), and defecation (p = 0.001). Decubitus (63.3%) and falls (53.4%) were the most frequent outcomes.

Conclusion: Unfinished care increases the occurrence of adverse events in hospitalized patients. These findings are consistent with the results of studies conducted to date. Effective interventions are found in the area of resource management and increasing the relevant professional awareness of general nurses.

Keywords: Adverse event; Patient assistance; Rationed nursing care; Unfinished care; Unfinished nursing work

Literatura

1. Aiken LH, Clarke SP, Sloane DM, Sochalski JA, Busse R, Clarke H, et al. (2001). Nurses’ reports on hospital care in five countries. Health Aff 20(3): 43–53. DOI: 10.1377/hlthaff.

2. Bail K, Grealish L (2016). ‘Failure to Maintain’: A theoretical proposition for a new quality indicator of nurse care rationing for complex older people in hospital. Int J Nurs Stud 63: 146–161. DOI: 10.1016/j.ijnur­stu.2016.08.001.

3. Gurková E, Bartoníčková D, Mikšová Z, Labudíková M, Chocholková D (2021). Reasons for unfinished nursing care from the perspective of nurses from regional and university hospitals. Kontakt 23(4): 281–288. DOI: 10.32725/kont­.2021.026.

4. Gustafsson N, Leino-Kilpi H, Prga I, Suhonen R, Stolt M, RANCARE consortium COST Action – CA15208 (2020). Missed Care from the Patient’s Per­spective – A Scoping Review. Patient Prefer Adherence 14: 383–400. DOI: 10.2147/PPA.S238024.

5. Jarošová D, Marková I (2023). Rationing of nursing care and nurses’ perception in acute inpatient care in selected regions of the Czech Republic. Kontakt 25(2): 93–99. DOI: 10.32725/kont­.2023.011.

6. Jarošová D, Zeleníková R (2019). Unfinished nursing care – the first pilot study in the Czech Republic. Kontakt 21(4): 388–394. DOI: 10.32725/kont­.2019.048.

7. Jarošová D, Gurková E, Zeleníková R, Plevová I, Janíková E (2021). Hospital and unit variables of missed nursing care in acute care hospitals: A cross-sectional study. J Clin Nurs 30(7–8): 1099–1110. DOI: 10.1111/jocn.15655.

8. Jarošová D, Zeleníková R, Plevová I, Mynaříková E, Kachlová M (2022). Differences in the Incidence of Adverse Events in Acute Care Hospitals: Results of a Multicentre Study. Int J Environ Res Public Health 19(9): 5238. DOI: 10.3390/ijerph19095238.

9. Jones TL (2014). Validation of the Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument. Nurs Forum 49(2): 77–87. DOI: 10.1111/nuf.12076.

10. Jones TL, Hamilton P, Murry N (2015). Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. Int J Nurs Stud 52(6): 1121–1137. DOI: 10.1016/j. ijnurstu.2015­.02.012.

11. Kalánková D, Bartoníčková D, Žiaková K (2019a). Predictors of missed, rationed and unfinished nursing care. Ošetrovateľstvo: teória, výskum, vzdelávanie 9(2): 43–48.

12. Kalánková D, Gurková E, Zeleníková, R, Žiaková K (2019b). Application of measuring tools in the assessment of the phenomenon of rationing/mis­sed/unfinished care. Kontakt 21(1): 65–73. DOI: 10.32725/kont­.2018.001.

13. Kalánková D, Kirwan M, Bartoníčková D, Cubelo F, Žiaková K, Kurucová R (2020). Missed, rationed or unfinished nursing care: A scoping review of patient outcomes. J Nurs Manag 28(8): 1783–1797. DOI: 10.1111/jonm.12978.

14. Kalánková D, Žiaková K, Kurucová R (2019c). Approaches to understanding the phenomenon of missed/rationed/un­finished care – a literature review. Cent Eur J Nurs Midw 10(1): 1005–1016. DOI: 10.15452/CEJNM­.2019.10.0007.

15. Kalisch BJ (2006). Missed nursing care: A qualitative study. J Nurs Care Qual 21(4): 306–313. DOI: 10.1097/00001786–200610000–00006.

16. Kalisch BJ, Landstrom GL, Hinshaw AS (2009). Missed nursing care: a concept analysis. J Adv Nurs 65(7): 1509–1517. DOI: 10.1111/j.1365–2648.

17. Kalisch BJ, Tschannen D, Lee H, Friese CR (2011). Hospital variation in missed nursing care. Am J Med Qual 26(4): 291–299. DOI: 10.1177/106286­0610395929.

18. Mandal L, Seethalakshmi A, Rajendrababu A (2020). Rationing of nursing care, a deviation from holistic nursing: A systematic review. Nurs Philos 21(1): e12257. DOI: 10.1111/nup.12257.

19. Neugebauer J, Tóthová V, Chloubová I, Hajduchová H, Brabcová I, Prokešová R (2021). Příčiny a intervence medikačního pochybení ve zdravotnických zařízeních [Causes and interventions of medication errors in healthcare facilities]. Čes Slov Farm 70: 43–50. DOI: 10.5817/CSF2021–2–43 (Czech).

20. Plevová I, Jarošová D, Janíková E, Zeleníková R, Mynaříková E, Polanská A (2020). Přidělovaná ošetřovatelská péče jako jeden z indikátorů výskytu medikačního pochybení [Rationed nursing care as one of the indicators of the occurrence of medication errors]. Vnitr Lek 66(7): e31–e38. DOI: 10.36290/vnl.2020­.137 (Czech).