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Missed Intensive Nursing Care Scale: Results From an Italian Validation Study
Ilaria de Barbieri1,2, Martina Dato1, Lisa Grego1
1Laboratory of Studies and Evidence Based Nursing, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy.
Background:
Unfinished Nursing Care (UNC) refers to essential patient care that is postponed or neglected, significantly impacting outcomes such as increased morbidity, mortality and hospital-acquired infections. In Intensive Care Units (ICUs), the complexity of patient conditions results in higher UNC rates, particularly for basic care interventions. The Missed Intensive Nursing Care Scale (MINCS) assesses the frequency and types of missed care in these settings.
Aim:
This study aimed to translate, culturally adapt and validate MINCS for use in the Italian ICU context, ensuring its psychometric robustness.
Study Design:
A methodological research for translation, cross-cultural adaptation and validation was conducted in two hospitals in north-eastern Italy, involving general, neurosurgical and cardiothoracic ICUs. The process included translation, back-translation, expert evaluation, pilot testing and psychometric analysis of MINCS-Italy (MINCS-IT) using Cronbach's alpha, Exploratory Factor Analysis (EFA) and Rasch analysis.
Results:
A total of 135 ICU nurses participated in the study, 76.3% were female, and an average ICU experience of 11.1 years. The final version of MINCS-IT contained 48 items, divided into three sections: demographics, elements of missed nursing care (34 items, α = 0.92), and reasons for missed care (14 items, α = 0.94). EFA revealed a five-factor structure for elements of missed care (53.2% variance explained) and a two-factor structure for reasons (64.9% variance explained). Rasch analysis supported item validity, except for one item ("Assessing patient nutritional status"), which showed suboptimal values.
Conclusions:
The MINCS-IT is a reliable tool for assessing missed nursing care in Italian ICUs, addressing both fundamental and complex patient needs. Its comprehensive approach supports targeted interventions to improve care quality.
Relevance To Clinical Practise:
The MINCS-IT enables nurse managers to identify missed care patterns, fostering improvements in nursing practises and patient-family care outcomes, ultimately elevating ICU standards.
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