Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review
Abstract 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-i...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-03-01
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| Series: | Human Resources for Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12960-023-00807-7 |
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| author | Abdulazeez Imam Sopuruchukwu Obiesie David Gathara Jalemba Aluvaala Michuki Maina Mike English |
| author_facet | Abdulazeez Imam Sopuruchukwu Obiesie David Gathara Jalemba Aluvaala Michuki Maina Mike English |
| author_sort | Abdulazeez Imam |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-09T22:53:46Z |
| format | Article |
| id | doaj.art-4b64a2fa1089439196e32ea7c043c5e7 |
| institution | Directory Open Access Journal |
| issn | 1478-4491 |
| language | English |
| last_indexed | 2024-04-09T22:53:46Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Human Resources for Health |
| spelling | doaj.art-4b64a2fa1089439196e32ea7c043c5e72023-03-22T11:31:22ZengBMCHuman Resources for Health1478-44912023-03-0121112110.1186/s12960-023-00807-7Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic reviewAbdulazeez Imam0Sopuruchukwu Obiesie1David Gathara2Jalemba Aluvaala3Michuki Maina4Mike English5KEMRI-Wellcome Trust Research ProgrammeCentre for Evidence Based Intervention, Department of Social Policy and Intervention, University of OxfordKEMRI-Wellcome Trust Research ProgrammeKEMRI-Wellcome Trust Research ProgrammeKEMRI-Wellcome Trust Research ProgrammeKEMRI-Wellcome Trust Research ProgrammeAbstract 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.https://doi.org/10.1186/s12960-023-00807-7Quality of careDeveloping countriesNursesPatient safetyOmission of careRationing care |
| spellingShingle | Abdulazeez Imam Sopuruchukwu Obiesie David Gathara Jalemba Aluvaala Michuki Maina Mike English Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review Human Resources for Health Quality of care Developing countries Nurses Patient safety Omission of care Rationing care |
| title | Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review |
| title_full | Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review |
| title_fullStr | Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review |
| title_full_unstemmed | Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review |
| title_short | Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review |
| title_sort | missed nursing care in acute care hospital settings in low income and middle income countries a systematic review |
| topic | Quality of care Developing countries Nurses Patient safety Omission of care Rationing care |
| url | https://doi.org/10.1186/s12960-023-00807-7 |
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