Care accommodation in the acute care setting: Missed care or not?

To explain how nurses care for patients with stroke in the acute setting, when working within constraints.

Internationally, health care environments are experiencing constraints such as reduced staffing levels, and lack of time and resources. In such circumstances, patient care is often of poorer quality or missed entirely.

Classic grounded theory methodology was used to explain how care is provided within the acute care setting for patients following stroke. Data were collected using unstructured interviews with 32 nurses.

Care accommodation, a typology of caring, was generated consisting of functional caring, assisted self-caring and ideal caring. Depending on the degree of constraint, nurses consciously or subconsciously prioritize care, potentially leading to missed care.

Care accommodation elucidates what happens to care delivery with limited resources. Missed care may result from engaging with care accommodation, a factor that nurses and managers need to consider in care delivery.

Care accommodation provides new insight and understanding for management of the daily challenges nurses face, thus informing nursing management that supports nurses advocating at higher levels for resources to provide necessary environments and strategies to reduce missed care.