Developing policies and actions in response to missed nursing care: A consensus process

Area of Science:

• Nursing
• Healthcare Policy
• Patient Safety

Background:

• Missed nursing care (MNC) is a growing international concern, referring to necessary patient care that nurses cannot provide or must delay.
• Despite its significance, MNC has not been effectively translated into actionable policies or documented interventions.
• This study addresses the need for a structured approach to understand and manage MNC within a specific healthcare context.

Purpose of the Study:

• To support the development of effective policies and actions to address missed nursing care (MNC).
• To adapt the concept of MNC to the Italian cultural context and establish a common terminology.
• To create a systematic framework for measuring and intervening in cases of MNC.

Main Methods:

• A consensus development method was employed.
• Involved a nominal group of experts, policymakers, and nursing leaders.
• Included input from 218 nurses, primarily at managerial levels.

Main Results:

• Eight consensus statements were approved to make MNC (termed Compromised Nursing Care - CNC) culturally acceptable in Italy.
• Statements cover measuring CNC to enhance patient safety, selecting and optimizing measurement tools, and analyzing data.
• The consensus also addresses designing interventions to prevent/minimize CNC, assessing their effectiveness, and disseminating findings.

Conclusions:

• The term Compromised Nursing Care (CNC) was adopted as a culturally appropriate synonym for Missed Nursing Care (MNC) in Italy, facilitating open discussion.
• The developed consensus statements provide a systematic approach from measurement to re-measurement after interventions.
• These statements offer guidance for decision-makers to implement policies aimed at improving care quality and patient safety by reducing MNC.