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.
Nursing Business and Health Systems, University of Michigan School of Nursing, 400 N Ingalls Street, Ann Arbor, MI 48109, USA. bkalisch@umich.edu
Beatrice J
BJ
Kalisch
Reg Arthur
RA
Williams
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