It could be hardly doubted that the delivery of care to patients in appropriate and timely manner has a direct positive influence on their well-being. However, when the care is missed (or left undone), patient outcomes and the overall condition of clinical settings could be significantly aggravated. Therefore, the primary focus of this paper is the concept of missed care that will be defined and investigated by referencing to theoretical and practical scholarly literature. Also, the notions of nurse-sensitive indicators, quality improvement, and work setting will be employed to give the primary issue additional context.
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Missed Care Defined
First of all, it is essential to provide a definition of missed care. The article by Jones, Hamilton, and Murry (2015) states that missed care (also referred to as unfinished nursing care, implicitly rationed care, and care left undone) is a “distinct form of underuse,” and it could be conceptualized as a three-stage process, comprising “a problem (resource/time scarcity), a process (clinical decision making to prioritize and ration care), and an outcome (care left undone)” (p. 1122). Lake, Germack, and Viscardi (2016), the authors state that missed care refers to any aspect of required nursing activity that is left undone or delayed.
Further, it is of high importance to discuss how nurse-sensitive indicator relates to the concept of missed care. According to the definition of American Nurses Association, which is cited in the article by Heslop and Lu (2014), nurse-sensitive indicators (NSCs) are “those indicators that capture care or its outcomes most affected by nursing care” (p. 2471). It is also stated that the concept of NSCs includes structural, process, and outcome terms (Heslop & Lu, 2014). Thus, it should be suggested that the omission of any constituent of NSCs translates into insufficient nursing care.
Integration of Theory and Evidence-Based Guidelines
Two previous subsections evidently represent several theoretical perspectives on the concept under discussion and related notions. It is also appropriate to mention the article by Carthon, Lasater, Sloane, and Kutney-Lee (2015), in which the authors suggest that one of the explanations for missed care is the inadequate resourcing of work settings. In their opinion, missed care is defined as the nursing activity that is considered important by a clinical nurse, but left undone of the shift because of the lack of time (Carthon et al., 2015). However, the primary conclusion of the article by Carthon et al. (2015) is that missed care is linked directly to higher readmission rates among the patients.
Impact of Missed Care on Quality Improvement
On the basis of previously identified evidence from scholarly literature and research, it is possible to state that missed care aggravates quality improvement in such areas as patient outcomes and clinical performance. However, the article by Lake et al. (2016) discusses this question in more details as the study’s primary scope is the relation between missed care and patient satisfaction. As the result of the cross-sectional study conducted by the authors, it was identified that patients who experienced missed nursing care, rated the overall perception of hospitalization period as less satisfactory than patients who did not encounter care left undone (Lake et al., 2016).
Missed Care Tailored to the Current Work Setting
Since I am working as a nurse in a hospital setting, the topic of missed care relates directly to my occupation. The research that is conducted in this paper has helped me to acquire a more profound understanding of causes and consequences of unfinished nursing care. In conclusion, I should state that I will employ the identified theoretical and practical guidelines into my working routine.
Carthon, J. M. B., Lasater, K. B., Sloane, D. M., & Kutney-Lee, A. (2015). The quality of hospital work environments and missed nursing care is linked to heart failure readmissions: A cross-sectional study of US hospitals. BMJ Quality & Safety, 24(4), 255-263.
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Heslop, L., & Lu, S. (2014). Nursing‐sensitive indicators: A concept analysis. Journal of Advanced Nursing, 70(11), 2469-2482.
Jones, T. L., Hamilton, P., & Murry, N. (2015). Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International journal of nursing studies, 52(6), 1121-1137.
Lake, E. T., Germack, H. D., & Viscardi, M. K. (2016). Missed nursing care is linked to patient satisfaction: a cross-sectional study of US hospitals. BMJ Quality & Safety, 25(7), 535-543.