title: Factors associated with rushed and missed resident care in western Canadian nursing homes: a cross-sectional survey of health care aides.
abstract: OBJECTIVE
  To describe the nature, frequency and factors associated with care that was rushed or missed by health care aides in western Canadian nursing homes.
  
  
  BACKGROUND
  The growing number of nursing home residents with dementia has created job strain for frontline health care providers, the majority of whom are health care aides. Due to the associated complexity of care, health care aides are challenged to complete more care tasks in less time. Rushed or missed resident care are associated with adverse resident outcomes (e.g. falls) and poorer quality of staff work life (e.g. burnout) making this an important quality of care concern.
  
  
  METHODS
  Cross-sectional survey of health care aides (n = 583) working in a representative sample of nursing homes (30 urban, six rural) in western Canada.
  
  
  METHODS
  Data were collected in 2010 as part of the Translating Research in Elder Care study. We collected data on individual health care aides (demographic characteristics, job and vocational satisfaction, physical and mental health, burnout), unit level characteristics associated with organisational context, facility characteristics (location, size, owner/operator model), and the outcome variables of rushed and missed resident care.
  
  
  RESULTS
  Most health care aides (86%) reported being rushed. Due to lack of time, 75% left at least one care task missed during their previous shift. Tasks most frequently missed were talking with residents (52% of health care aides) and assisting with mobility (51%). Health care aides working on units with higher organisational context scores were less likely to report rushed and missed care.
  
  
  CONCLUSIONS
  Health care aides frequently report care that is rushed and tasks omitted due to lack of time.
  
  
  CONCLUSIONS
  Considering the resident population in nursing homes today--many with advanced dementia and all with complex care needs--health care aides having enough time to provide physical and psychosocial care of high quality is a critical concern.
authors.affiliation: Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB, Canada.|Faculty of Nursing, University of Alberta, Level 5, Edmonton Clinic Health Academy, Edmonton, AB, Canada.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Knopp-Sihota
authors.affiliation: Faculty of Nursing, University of Alberta, Level 5, Edmonton Clinic Health Academy, Edmonton, AB, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Niehaus
authors.affiliation: Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.|School of Nursing, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Squires
authors.affiliation: Department of Family Medicine, University of Calgary, Calgary, AB, Canada.
authors.forename: Peter G
authors.initials: PG
authors.lastname: Norton
authors.affiliation: Faculty of Nursing, University of Alberta, Level 5, Edmonton Clinic Health Academy, Edmonton, AB, Canada.
authors.forename: Carole A
authors.initials: CA
authors.lastname: Estabrooks
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003430:Cross-Sectional Studies; D003704:Dementia / Q000451:nursing*; D005260:Female; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009728:Nursing Assistants / Q000523:psychology*; D009735:Nursing Homes / Q000592:standards*; D011795:Surveys and Questionnaires; D016526:Workload
keywords: health care aides; missed care; nursing home; organisational context; quality and safety; rushed care