title: Missed nursing care and predicting factors in the Italian medical care setting.
abstract: Missed nursing care (MNC), such as nursing care omitted or delayed, has not been measured in the Italian context where several cost containment interventions affect the care offered in medical units. The aim of the study is to identify the amount, type, and reasons for MNC in the Italian medical care setting and to explore the factors that affect the occurrence of MNC. A 3-month longitudinal survey was carried out followed by a cross-sectional study design in 12 north eastern acute medical units. A total of 314 nursing staff members were involved. Multivariate logistic regression was performed to identify the predictors of MNC. Patient ambulation (91.4 %), turning the patient every 2 h (74.2 %), and right timing in administering medications (64.6 %) were the most perceived MNC. Among the most frequent reasons were the unexpected rise in patient volume or critical conditions (95.2 %), inadequate numbers of staff (94.9 %), and large numbers of admissions/discharges (93.3 %). The R (2) 33.2 % of the variance in MNC were explained by a full-time position (OR 4.743, 95 % CI 1.146-19.629), communication tensions between Registered Nurses and Nurses' Aides (OR 1.601, 95 % CI 1.020-2.515), the amount of experience in medical unit (OR 1.564, 95 % CI 1.021-2.397), and the amount of daily care offered by Nurses' Aides (1.039, 95 % CI 1.011-1.067). A substantial amount of basic and clinically relevant nursing interventions was perceived to be missed, and this may lead to an increase in negative outcomes for patients admitted to a medical unit. Appropriate standards of nursing care should be adopted urgently in medical units aiming to protect frail patients.
authors.affiliation: Udine University, Viale Ungheria 20, 33100, Udine, Italy, alvisa.palese@uniud.it.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
authors.forename: Elisa
authors.initials: E
authors.lastname: Ambrosi
authors.forename: Letizia
authors.initials: L
authors.lastname: Prosperi
authors.forename: Annamaria
authors.initials: A
authors.lastname: Guarnier
authors.forename: Paolo
authors.initials: P
authors.lastname: Barelli
authors.forename: Paola
authors.initials: P
authors.lastname: Zambiasi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Allegrini
authors.forename: Letizia
authors.initials: L
authors.lastname: Bazoli
authors.forename: Paola
authors.initials: P
authors.lastname: Casson
authors.forename: Meri
authors.initials: M
authors.lastname: Marin
authors.forename: Marisa
authors.initials: M
authors.lastname: Padovan
authors.forename: Michele
authors.initials: M
authors.lastname: Picogna
authors.forename: Patrizia
authors.initials: P
authors.lastname: Taddia
authors.forename: Daniele
authors.initials: D
authors.lastname: Salmaso
authors.forename: Paolo
authors.initials: P
authors.lastname: Chiari
authors.forename: Oliva
authors.initials: O
authors.lastname: Marognolli
authors.forename: Federica
authors.initials: F
authors.lastname: Canzan
authors.forename: Silvia
authors.initials: S
authors.lastname: Gonella
authors.forename: Luisa
authors.initials: L
authors.lastname: Saiani
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009726:Nurses; D009732:Nursing Care / Q000592:standards* / Q000639:trends; D010362:Patients' Rooms / Q000592:standards; D000078329:Workforce; D016526:Workload / Q000592:standards*
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