Prevalence, patterns and predictors of nursing care left undone in European hospitals: results from the multicountry cross-sectional RN4CAST study.
BACKGROUND
Little is known of the extent to which nursing-care tasks are left undone as an international phenomenon.


OBJECTIVE
The aim of this study is to describe the prevalence and patterns of nursing care left undone across European hospitals and explore its associations with nurse-related organisational factors.


METHODS
Data were collected from 33 659 nurses in 488 hospitals across 12 European countries for a large multicountry cross-sectional study.


RESULTS
Across European hospitals, the most frequent nursing care activities left undone included 'Comfort/talk with patients' (53%), 'Developing or updating nursing care plans/care pathways' (42%) and 'Educating patients and families' (41%). In hospitals with more favourable work environments (B=-2.19; p<0.0001), lower patient to nurse ratios (B=0.09; p<0.0001), and lower proportions of nurses carrying out non-nursing tasks frequently (B=2.18; p<0.0001), fewer nurses reported leaving nursing care undone.


CONCLUSIONS
Nursing care left undone was prevalent across all European countries and was associated with nurse-related organisational factors. We discovered similar patterns of nursing care left undone across a cross-section of European hospitals, suggesting that nurses develop informal task hierarchies to facilitate important patient-care decisions. Further research on the impact of nursing care left undone for patient outcomes and nurse well-being is required.
Institute of Nursing Science, University of Basel, , Basel, Switzerland.
Dietmar
D
Ausserhofer
Britta
B
Zander
Reinhard
R
Busse
Maria
M
Schubert
Sabina
S
De Geest
Anne Marie
AM
Rafferty
Jane
J
Ball
Anne
A
Scott
Juha
J
Kinnunen
Maud
M
Heinen
Ingeborg Strømseng
IS
Sjetne
Teresa
T
Moreno-Casbas
Maria
M
Kózka
Rikard
R
Lindqvist
Marianna
M
Diomidous
Luk
L
Bruyneel
Walter
W
Sermeus
Linda H
LH
Aiken
René
R
Schwendimann
D019091:Critical Pathways; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D019300:Medical Errors; D009723:Nurse-Patient Relations; D009732:Nursing Care / Q000458:organization & administration / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000592:standards / Q000600:supply & distribution*; D057184:Practice Patterns, Nurses'; D015995:Prevalence; D016138:Walking
Health services research; Nurses; Patient safety