A comparison of patient care units with high versus low levels of missed nursing care.
BACKGROUND
In a previous study, the nursing staff on 110 patient care units in 10 hospitals participated in a quantitative study of missed nursing care.


OBJECTIVE
The aim of this study was to gain an understanding of the differences in patient care units that had the most missed nursing care with those with the least missed nursing care.


METHODS
Focus groups were conducted with the registered nurse staff on the 5 units with the most missed nursing care and 5 units with the least missed care.


RESULTS
Ten themes were identified: (a) staffing levels, (b) communication, (c) collective orientation, (d) backup, (e) monitoring, (f) leadership, (g) long tenure, (h) unit size, (i) trust, and (j) accountability. Taken together, the predominant difference found was that units with the least missed care had higher teamwork.


CONCLUSIONS
Strategies for developing interventions to decrease missed care and increase teamwork are presented.
Titus Distinguished Professor of Nursing and Director, Nursing Business and Health Systems, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA. bkalisch@umich.edu
Beatrice J
BJ
Kalisch
Kate
K
Gosselin
Seung Hee
SH
Choi
D017144:Focus Groups; D006757:Hospital Units; D006801:Humans; D009732:Nursing Care / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000523:psychology* / Q000706:statistics & numerical data; D005791:Patient Care; D011785:Quality Assurance, Health Care