Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study

Background  Despite its association with patient safety, few studies on missed nursing care have been conducted in nursing homes. We aimed to describe individual and environmental factors in a sample of registered nurses (RNs) reporting missed nursing care in nursing homes, and to explore the associ...

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Main Authors: Sara Campagna, Alessio Conti, Marco Clari, Ines Basso, Veronica Sciannameo, Paola Di Giulio, Valerio Dimonte
Format: Article
Language:English
Published: Kerman University of Medical Sciences 2022-08-01
Series:International Journal of Health Policy and Management
Subjects:
Online Access:https://www.ijhpm.com/article_4034_6025f67aad9b8988e76a5312fae9fddc.pdf
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author Sara Campagna
Alessio Conti
Marco Clari
Ines Basso
Veronica Sciannameo
Paola Di Giulio
Valerio Dimonte
author_facet Sara Campagna
Alessio Conti
Marco Clari
Ines Basso
Veronica Sciannameo
Paola Di Giulio
Valerio Dimonte
author_sort Sara Campagna
collection DOAJ
description Background  Despite its association with patient safety, few studies on missed nursing care have been conducted in nursing homes. We aimed to describe individual and environmental factors in a sample of registered nurses (RNs) reporting missed nursing care in nursing homes, and to explore the association between these factors and missed nursing care. Methods  In the present, multicentre cross-sectional study, 217 RNs from 43 nursing homes in Northern Italy reported all episodes of missed nursing care (ie, any aspect of required care that was omitted or delayed) that occurred in the 20 most dependent residents (according to RNs’ judgement; 860 residents in total) over 3 consecutive days. Multilevel multivariable logistic regression models were used to test possible explanatory factors of missed nursing care (individual, work-related, organisational, and work environment factors), which were entered in a step-wise manner. Results  Younger RNs (P = .026), freelance RNs (P = .046), RNs with a permanent contract (P = .035), and those working in publicly-owned nursing homes reported more episodes of missed nursing care (P < .012). Public ownership (odds ratio [OR] = 9.88; 95% CI 2.22–44.03; P = .003), a higher proportion of residents with severe clinical conditions (OR = 2.45; 95% CI 1.12–5.37; P = .025), a lower proportion of RNs (OR = 2.24; 95% CI 1.10–4.54; P = .026), and perceived lack of time to care for residents (OR = 2.33; 95% CI 1.04–5.26; P = .041) were statistically significantly associated with missed nursing care. Conclusion  Factors associated with missed nursing care are similar in hospitals and nursing homes, and include heavy workload and perceived lack of time for care. Because missed nursing care in nursing homes represents tasks performed specifically by RNs, missed nursing care in this setting should be measured in terms of these tasks. An optimal skill mix is crucial to guarantee not only comfort and basic care for nursing home residents, but also good outcomes for residents with severe clinical conditions.
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spelling doaj.art-7b46932c64c44427b66056ad5446ce592023-03-07T09:11:26ZengKerman University of Medical SciencesInternational Journal of Health Policy and Management2322-59392022-08-011181334134110.34172/ijhpm.2021.234034Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional StudySara Campagna0Alessio Conti1Marco Clari2Ines Basso3Veronica Sciannameo4Paola Di Giulio5Valerio Dimonte6Department of Public Health and Pediatrics, University of Torino, Torino, ItalyDepartment of Public Health and Pediatrics, University of Torino, Torino, ItalyDepartment of Public Health and Pediatrics, University of Torino, Torino, ItalyDepartment of Public Health and Pediatrics, University of Torino, Torino, ItalyUnit of Biostatistics, Epidemiology and Public Health, University of Padova, Padua, ItalyDepartment of Public Health and Pediatrics, University of Torino, Torino, ItalyDepartment of Public Health and Pediatrics, University of Torino, Torino, ItalyBackground  Despite its association with patient safety, few studies on missed nursing care have been conducted in nursing homes. We aimed to describe individual and environmental factors in a sample of registered nurses (RNs) reporting missed nursing care in nursing homes, and to explore the association between these factors and missed nursing care. Methods  In the present, multicentre cross-sectional study, 217 RNs from 43 nursing homes in Northern Italy reported all episodes of missed nursing care (ie, any aspect of required care that was omitted or delayed) that occurred in the 20 most dependent residents (according to RNs’ judgement; 860 residents in total) over 3 consecutive days. Multilevel multivariable logistic regression models were used to test possible explanatory factors of missed nursing care (individual, work-related, organisational, and work environment factors), which were entered in a step-wise manner. Results  Younger RNs (P = .026), freelance RNs (P = .046), RNs with a permanent contract (P = .035), and those working in publicly-owned nursing homes reported more episodes of missed nursing care (P < .012). Public ownership (odds ratio [OR] = 9.88; 95% CI 2.22–44.03; P = .003), a higher proportion of residents with severe clinical conditions (OR = 2.45; 95% CI 1.12–5.37; P = .025), a lower proportion of RNs (OR = 2.24; 95% CI 1.10–4.54; P = .026), and perceived lack of time to care for residents (OR = 2.33; 95% CI 1.04–5.26; P = .041) were statistically significantly associated with missed nursing care. Conclusion  Factors associated with missed nursing care are similar in hospitals and nursing homes, and include heavy workload and perceived lack of time for care. Because missed nursing care in nursing homes represents tasks performed specifically by RNs, missed nursing care in this setting should be measured in terms of these tasks. An optimal skill mix is crucial to guarantee not only comfort and basic care for nursing home residents, but also good outcomes for residents with severe clinical conditions.https://www.ijhpm.com/article_4034_6025f67aad9b8988e76a5312fae9fddc.pdfmissed nursing carenursing homestaffingwork factorsitaly
spellingShingle Sara Campagna
Alessio Conti
Marco Clari
Ines Basso
Veronica Sciannameo
Paola Di Giulio
Valerio Dimonte
Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study
International Journal of Health Policy and Management
missed nursing care
nursing home
staffing
work factors
italy
title Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study
title_full Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study
title_fullStr Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study
title_full_unstemmed Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study
title_short Factors Associated With Missed Nursing Care in Nursing Homes: A Multicentre Cross-sectional Study
title_sort factors associated with missed nursing care in nursing homes a multicentre cross sectional study
topic missed nursing care
nursing home
staffing
work factors
italy
url https://www.ijhpm.com/article_4034_6025f67aad9b8988e76a5312fae9fddc.pdf
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