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Missed Nursing Care in Nursing Homes and Causes: A Systematic Review
Simone Cosmai1, Valentina Trezzi1, Laura Mansi1
1Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, Milan.
Introduction:
Missed nursing care refers to necessary nursing care activities that, due to various factors, are either not provided, partially provided, or delayed from the planned schedule. Missed nursing care (MNC) is a significant issue in nursing homes, undermining care quality and increasing the risk of adverse events and preventable hospitalizations. This systematic review aims to identify the most frequently reported MNC by nursing staff in nursing homes and the associated causes.
Methods:
The review was conducted following the guidelines of the "JBI Manual for Evidence Synthesis" and using the PRISMA ScR checklist. A search yielded 1468 articles: 85 from PubMed, 1115 from Scopus, 164 from Embase, and 104 from CINAHL. Screening removed 1386 duplicates, identifying 82 potentially relevant articles. After title and abstract review, 72 were excluded for irrelevance, resulting in 9 studies included in this review. Study selection defined inclusion criteria, focusing on quantitative studies involving registered nurses working in nursing homes.
Results:
The most frequently omitted nursing care activities in nursing homes include patient mobilization, assistance with feeding, and personal hygiene care. Key causes identified were staff shortages, high patient care complexity, and limited resource availability.
Discussion:
The findings confirm that MNC in nursing homes is primarily influenced by organizational and structural factors, requiring a systemic approach to improve care quality. Targeted interventions, such as better resource planning, improved staff management, and measures to enhance nurse well-being, could significantly reduce the incidence of missed care. Future research, particularly longitudinal studies, may provide further insights into more effective prevention of MNC, while the development of specific assessment tools for nursing homes could enhance MNC measurement and support targeted interventions.
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