Missed Nursing Care, Patient Outcomes and Care Outcomes in Selected Hospitals in Southern Nigeria
Abstract
Mildred Edet John, Mary Achi Mgbekem, Alberta David Nsemo and Gloria I Maxwell
Background: It is the right of every patient to receive necessary care appropriately, safely, and at the right time. However nurse shortages cause omission of less critical nursing tasks by nurses. The aims of the study were to examine the nature and prevalence of missed care; and to assess relationship between missed care and selected care outcomes.
Methods: Mixed method was used (descriptive and intervention) to collect data from186 nurses providing direct adult care in 4 hospitals, and 120 patients/relatives. Ethical clearance was obtained from the HREC of Cross River State Ministry of Health. Nurses identified activities omitted in part or whole, or delayed in the previous seven days from a validated list of required care activities. Intervention comprised capacity building on certain care issues. Data were collected through researcher-developed and validated questionnaires. Descriptive and inferential statistics were used analyse data on SPSS 18.0.
Results: Most nurses (83.9%) reported they had left one or more care activities undone. At post-test experimental group mean reduced significantly. Care most missed were routine bath (34.9%), spiritual support (33.9%), assessing effectiveness of pain medication (28.0%), patient education (26.3%), pain assessment before administering medication (25.8%), etc. Others like chronic wound care and updating care plans were delayed but not totally missed. After intervention both prevalence and overall Means of missed care for experimental group reduced significantly (p = 0.001). Missed care was significantly related to all outcomes. Higher mean scores on missed care related with poor rating of outcomes, except on one outcome. Study did not consider staffing levels.
Conclusion: Nurses reported frequently leaving “non-critical” care activities undone. Closer supervision is required to reduce missed care in staff