Development and psychometric testing of a tool to measure missed nursing care.
BACKGROUND
In a qualitative study, medical-surgical and intensive care staff nurses reported that they did not complete a significant amount of nursing care on regular basis. Thus, it was determined that a quantitative tool was needed to measure the amount and type of missed nursing care and the reasons for missing care.


OBJECTIVE
The authors report the results of a psychometric evaluation of this tool (The Missed Nursing Care Survey [MISSCARE Survey]) to measure missed nursing care (part A) and the reasons for missed nursing care (part B).


METHODS
Two studies were conducted--study 1 (n = 459) and study 2 (n = 639). A sample of staff nurses was drawn from 35 medical-surgical, rehabilitation, and intensive care patient units in 4 acute care hospitals.


RESULTS
Acceptability was high, with 85% of the respondents answering all items on the survey. Factor analysis with Varimax rotation resulted in a 3-factor solution for part 2 (communication, labor resources, and material resources). Cronbach alpha values ranged from 0.64 to 0.86. Confirmatory factor analysis demonstrated a good fit of the data. Using a contrasting group approach, a comparison of nurse's perceptions of missed care on intensive care units versus rehabilitation units resulted, as hypothesized, in a significantly lower amount of missed care on intensive care units. Pearson correlation coefficient on a test-retest of the same subjects yielded a value of 0.87 on part A and 0.86 on part B.


CONCLUSIONS
Although further validation of the MISSCARE Survey is needed, current evidence demonstrates that the tool meets stringent psychometric standards.
Kalisch
Beatrice J
BJ
Nursing Business and Health Systems, University of Michigan School of Nursing, 400 N Ingalls Street, Ann Arbor, MI 48109, USA. bkalisch@umich.edu
Williams
Reg Arthur
RA
D003625:Data Collection / Q000379:methods*; D005163:Factor Analysis, Statistical; D017144:Focus Groups; D006801:Humans; D019300:Medical Errors / Q000451:nursing / Q000706:statistics & numerical data*; D015146:Midwestern United States; D015401:Nursing Administration Research / Q000379:methods*; D009732:Nursing Care / Q000706:statistics & numerical data*; D015403:Nursing Evaluation Research / Q000379:methods*; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000458:organization & administration* / Q000523:psychology; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration; D011594:Psychometrics; D036301:Qualitative Research; D011787:Quality of Health Care / Q000706:statistics & numerical data; D013996:Time and Motion Studies; D016526:Workload / Q000706:statistics & numerical data