Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review.
Care left undone
Developing countries
Missed care
Nurses
Omission of care
Patient safety
Quality of care
Rationing care
Unmet patient needs
Journal
Human resources for health
ISSN: 1478-4491
Titre abrégé: Hum Resour Health
Pays: England
ID NLM: 101170535
Informations de publication
Date de publication:
14 03 2023
14 03 2023
Historique:
received:
21
06
2022
accepted:
23
02
2023
entrez:
15
3
2023
pubmed:
16
3
2023
medline:
17
3
2023
Statut:
epublish
Résumé
Missed nursing care undermines nursing standards of care and minimising this phenomenon is crucial to maintaining adequate patient safety and the quality of patient care. The concept is a neglected aspect of human resource for health thinking, and it remains understudied in low-income and middle-income country (LMIC) settings which have 90% of the global nursing workforce shortages. Our objective in this review was to document the prevalence of missed nursing care in LMIC, identify the categories of nursing care that are most missed and summarise the reasons for this. We conducted a systematic review searching Medline, Embase, Global Health, WHO Global index medicus and CINAHL from their inception up until August 2021. Publications were included if they were conducted in an LMIC and reported on any combination of categories, reasons and factors associated with missed nursing care within in-patient settings. We assessed the quality of studies using the Newcastle Ottawa Scale. Thirty-one studies met our inclusion criteria. These studies were mainly cross-sectional, from upper middle-income settings and mostly relied on nurses' self-report of missed nursing care. The measurement tools used, and their reporting were inconsistent across the literature. Nursing care most frequently missed were non-clinical nursing activities including those of comfort and communication. Inadequate personnel numbers were the most important reasons given for missed care. Missed nursing care is reported for all key nursing task areas threatening care quality and safety. Data suggest nurses prioritise technical activities with more non-clinical activities missed, this undermines holistic nursing care. Improving staffing levels seems a key intervention potentially including sharing of less skilled activities. More research on missed nursing care and interventions to tackle it to improve quality and safety is needed in LMIC. PROSPERO registration number: CRD42021286897.
Sections du résumé
BACKGROUND
Missed nursing care undermines nursing standards of care and minimising this phenomenon is crucial to maintaining adequate patient safety and the quality of patient care. The concept is a neglected aspect of human resource for health thinking, and it remains understudied in low-income and middle-income country (LMIC) settings which have 90% of the global nursing workforce shortages. Our objective in this review was to document the prevalence of missed nursing care in LMIC, identify the categories of nursing care that are most missed and summarise the reasons for this.
METHODS
We conducted a systematic review searching Medline, Embase, Global Health, WHO Global index medicus and CINAHL from their inception up until August 2021. Publications were included if they were conducted in an LMIC and reported on any combination of categories, reasons and factors associated with missed nursing care within in-patient settings. We assessed the quality of studies using the Newcastle Ottawa Scale.
RESULTS
Thirty-one studies met our inclusion criteria. These studies were mainly cross-sectional, from upper middle-income settings and mostly relied on nurses' self-report of missed nursing care. The measurement tools used, and their reporting were inconsistent across the literature. Nursing care most frequently missed were non-clinical nursing activities including those of comfort and communication. Inadequate personnel numbers were the most important reasons given for missed care.
CONCLUSIONS
Missed nursing care is reported for all key nursing task areas threatening care quality and safety. Data suggest nurses prioritise technical activities with more non-clinical activities missed, this undermines holistic nursing care. Improving staffing levels seems a key intervention potentially including sharing of less skilled activities. More research on missed nursing care and interventions to tackle it to improve quality and safety is needed in LMIC. PROSPERO registration number: CRD42021286897.
Identifiants
pubmed: 36918941
doi: 10.1186/s12960-023-00807-7
pii: 10.1186/s12960-023-00807-7
pmc: PMC10015781
doi:
Types de publication
Systematic Review
Journal Article
Review
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
19Subventions
Organisme : Department of Health
ID : NIHR130812
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 207522
Pays : United Kingdom
Organisme : Wellcome Trust
ID : 092654
Pays : United Kingdom
Informations de copyright
© 2023. The Author(s).
Références
J Nurs Manag. 2021 Sep;29(6):1848-1856
pubmed: 33544403
J Nurs Manag. 2022 Mar;30(2):447-454
pubmed: 34719833
Rev Lat Am Enfermagem. 2017 Jul 10;25:e2877
pubmed: 28699991
Syst Rev. 2016 Dec 5;5(1):210
pubmed: 27919275
BMJ. 2015 Sep 04;351:h4672
pubmed: 26341898
Hum Resour Health. 2019 Mar 6;17(1):18
pubmed: 30841900
Nurs Philos. 2020 Jan;21(1):e12257
pubmed: 31429179
J Adv Nurs. 2021 Feb;77(2):550-564
pubmed: 33089553
Int J Nurs Stud. 2015 Jun;52(6):1121-37
pubmed: 25794946
J Adv Nurs. 2018 Jul;74(7):1474-1487
pubmed: 29517813
Int J Nurs Pract. 2020 Feb;26(1):e12812
pubmed: 31840875
Rev Lat Am Enfermagem. 2020 Feb 14;28:e3233
pubmed: 32074206
PLoS One. 2019 Dec 23;14(12):e0225814
pubmed: 31869340
Int J Nurs Stud. 2013 Feb;50(2):240-52
pubmed: 22560562
Int J Nurs Stud. 2022 Feb;126:104140
pubmed: 34933165
J Nurs Manag. 2020 Nov;28(8):2257-2265
pubmed: 31660656
J Clin Nurs. 2018 Oct;27(19-20):3768-3779
pubmed: 30039531
J Nurs Manag. 2015 Nov;23(8):1115-25
pubmed: 25345386
J Nurs Manag. 2020 Nov;28(8):1975-1985
pubmed: 32153061
J Nurs Scholarsh. 2009;41(2):202-10
pubmed: 19538705
Patient Prefer Adherence. 2020 Feb 25;14:383-400
pubmed: 32161449
Kaohsiung J Med Sci. 2021 Feb;37(2):82-91
pubmed: 33022855
Wellcome Open Res. 2021 Dec 21;6:359
pubmed: 35495089
Rev Lat Am Enfermagem. 2017 Dec 21;25:e2975
pubmed: 29267546
Int J Evid Based Healthc. 2015 Sep;13(3):132-40
pubmed: 26360830
BMJ Qual Saf. 2020 Jan;29(1):19-30
pubmed: 31171710
J Nurs Manag. 2020 Nov;28(8):2205-2215
pubmed: 32472718
J Clin Nurs. 2018 Jul;27(13-14):2887-2895
pubmed: 29633416
Rev Lat Am Enfermagem. 2021 Jun 28;29:e3461
pubmed: 34190951
Nurs Forum. 2021 Apr;56(2):273-283
pubmed: 33345335
Am J Med Qual. 2011 Jul-Aug;26(4):291-9
pubmed: 21642601
Int J Nurs Stud. 2013 Feb;50(2):230-9
pubmed: 23084600
J Nurs Manag. 2022 Jan;30(1):62-70
pubmed: 34590383
J Nurs Manag. 2020 Nov;28(8):1783-1797
pubmed: 32064694
J Nurs Manag. 2020 Nov;28(8):1986-1996
pubmed: 32173932
BMC Health Serv Res. 2022 Oct 4;22(1):1230
pubmed: 36195863
Nurs Ethics. 2022 Feb;29(1):35-48
pubmed: 34396804
Rev Lat Am Enfermagem. 2016 Nov 21;24:e2817
pubmed: 27878218
J Nurs Care Qual. 2006 Oct-Dec;21(4):306-13; quiz 314-5
pubmed: 16985399
Int J Health Plann Manage. 2014 Jan-Mar;29(1):3-25
pubmed: 23296644
J Egypt Public Health Assoc. 2021 Jul 20;96(1):22
pubmed: 34283331
Int J Nurs Pract. 2022 Oct;28(5):e13050
pubmed: 35294994
Int J Environ Res Public Health. 2019 May 14;16(10):
pubmed: 31091660
J Adv Nurs. 2009 Jul;65(7):1509-17
pubmed: 19456994
J Clin Nurs. 2018 Jun;27(11-12):2179-2188
pubmed: 29156087
J Nurs Manag. 2020 Nov;28(8):2103-2112
pubmed: 31433878
Int J Nurs Pract. 2022 Feb;28(1):e13031
pubmed: 34970817
Appl Nurs Res. 2018 Apr;40:163
pubmed: 29579493
J Nurs Adm. 2013 May;43(5):274-9
pubmed: 23615369
J Clin Nurs. 2010 Aug;19(15-16):2185-95
pubmed: 20659198
J Nurs Manag. 2020 Oct;28(7):1578-1588
pubmed: 32726867
PLoS One. 2016 Jan 25;11(1):e0147601
pubmed: 26808317
Int J Qual Health Care. 2008 Aug;20(4):227-37
pubmed: 18436556
Wellcome Open Res. 2021 Dec 23;6:363
pubmed: 35368905
Int J Nurs Stud. 2018 Feb;78:10-15
pubmed: 28844649
Rev Esc Enferm USP. 2019 Aug 19;53:e03470
pubmed: 31433012
J Clin Nurs. 2018 Jun;27(11-12):2248-2259
pubmed: 28859254
J Adv Nurs. 2022 Dec;78(12):4019-4033
pubmed: 36097637
BMJ Qual Saf. 2015 Apr;24(4):255-63
pubmed: 25672342
Milbank Mem Fund Q. 1966 Jul;44(3):Suppl:166-206
pubmed: 5338568