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Missed Nursing Care in Pediatrics.
Eileen T Lake1, Pamela B de Cordova2, Sharon Barton3
1Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania; elake@nursing.upenn.edu.
Hospital Pediatrics
|June 15, 2017
Summary
Pediatric nurses frequently miss essential care activities, especially in demanding work environments with high patient loads. Improving work conditions and reducing patient assignments can decrease missed nursing care and enhance patient safety.
Area of Science:
- Nursing Science
- Healthcare Quality Improvement
- Pediatric Patient Safety
Background:
- Missed nursing care is a recognized issue in adult hospital settings, potentially impacting patient outcomes.
- Empirical evidence regarding missed nursing care in pediatric populations remains limited.
- Understanding factors contributing to missed care in pediatric settings is crucial for improving quality.
Purpose of the Study:
- To quantify the frequency and patterns of missed nursing care in inpatient pediatric units.
- To investigate the association between missed nursing care and adverse work environments.
- To determine the relationship between nurse workload (patient assignments) and missed nursing care.
Main Methods:
- A cross-sectional study analyzed survey data from 2187 registered nurses in pediatric units (NICU, PICU, general pediatrics) across 223 US hospitals.
- Nurses reported on 12 essential nursing activities not performed due to time constraints during their last shift.
- Data included nurse-reported patient assignments and work environment ratings.
Main Results:
- Over half of pediatric nurses reported missing at least one necessary nursing activity.
- Missed care was significantly more prevalent in unfavorable work environments (1.9 activities) compared to favorable ones (1.2 activities).
- Each additional patient assigned to a nurse increased the likelihood of missed care by 70%, while better work environments reduced missed care by 40%.
Conclusions:
- Reducing nurse workload and fostering supportive work environments are key to minimizing missed nursing care in pediatric settings.
- Optimizing staffing levels and work conditions can enhance the quality of patient care in pediatric hospitals.
- Addressing environmental and workload factors is essential for improving pediatric patient safety and nursing practice.
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