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“Missed Nursing Care” Article by Kalisch

This is a critique of a qualitative study in nursing of the article Missed Nursing Care. The critique attempts to investigate whether the nursing research journal about the study is effective in the presentation of the findings, biased, and relevant in the nursing field. However, a better critique requires the researcher to understand the trends, challenges and nursing reports that are historically and currently useful in the field of nursing.

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This study attempts to determine “nursing care regularly missed on medical-surgical units and reasons for missed care” (Kalisch, 2006). Kalisch identified nine of such areas as ambulation, turning, delayed or missed feedings, patient teaching, discharge planning, emotional support, hygiene, intake and output documentation, and surveillance. Nursing staff reported seven of these concerns (Kalisch, 2006).

The researcher conducted a thorough study of existing works about the roles of nurses. The researcher observes that nurses have noticed challenges related to quality nursing, and patient safety that face nurses and nurse leaders of today. Kalisch established that these challenges relate to nursing staffing, mortality/failure to rescue, rates of infection, patient falls, length of stay, pressure ulcer, adverse events, complication after surgery, and patient satisfaction (Kalisch, 2006).

The researcher has established that no research has determined the relationship between aspects of missed nursing care and less staffing and negative consequences. According to Aiken and fellow researchers, the functions of nurses include “surveillance so as to avoid errors, ensure the quality of care; thus, too few staff result into insufficient surveillance” (Aiken et al, 2002). The researcher has concluded that a review of available literature revealed a lack of studies in this area (Bettany-Saltikov, 2012).

The researcher did not base the work on any existing theories or study framework. This is because there were no previous works in this area. However, the researcher relied on previous works by other scholars to provide a base for the study.

The study has two research questions. The researcher aimed at obtaining primary data from the study sample by asking open-ended questions in order to obtain rich information. The approach was appropriate because this was investigative research that did not confine the number of responses.

Qualitative studies do have elaborate definition of research variables so is this study. However, the researcher identified phenomena under investigation. Thus, the research relies heavily on research questions and approaches for guidance.

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Since the researcher did not define research variable due to qualitative research approach, there are no demographic variables attributed to this study.

This is a qualitative research design that focuses on the analysis of results the researcher obtained. The approach allows the researcher to obtain descriptive, interpretative, and inductive data. The repetitive process of qualitative design makes this open-ended technique due to changes that may occur during the research process. The researcher also used purposeful sampling in order to get data from its rich sources so as to get an in-depth view of the problem under investigation. In this case, the researcher targeted focus group, registered nurses, and nursing assistants.

The researcher used purposeful sampling in order to obtain in-depth knowledge of questions under study. The researcher used a representative data of 107 registered nurses, 15 licensed practical nurses, and 51 nursing assistants formed part of the focus discussion groups of 25 respondents. The researcher used job titles to group the respondents to facilitate communication of issues that some respondents may be reluctant to discuss in the presence of others.

This is an appropriate sample as the researcher avoided the issue of small sample sizes associated with qualitative studies. The research setting is also appropriate for the study as it involve a natural setting where issues under investigation take place. The researcher also had the opportunity of watching events as they transpire without interfering. Therefore, data collected is reliable.

The researcher took careful account of measurement instrument to ensure their technical aspects, reliability, validity, and avoidance of any possible bias. At the same time, instruments of the study were appropriate to the study i.e. they were easy to use.

The researcher used focus groups to collect data. This ensured that data collected had in-depth presentation of the problem under investigation. At the same time, the researcher ensured confidentiality of the participants. The discovery approach the researcher used in the study tends to be iterative as the study is interpretative. This method ensured that the researcher collects only relevant data to the problem.

The research transcribed all the “tape-recorded interviews, and then analysed the data with associates and finally alone” (Kalisch, 2006). Analyses involved statistical software (NVivo by QRS International). There was also application of a grounded theory and categorised similar data under themes. Further analysis captured the same issues from the first analysis. Thus, the research confirmed grounding approach using the third analysis. Analyses and approach ensured that the research discovered nine different aspects related to the problem under investigation.

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According to study analyses and results, the researcher was able to establish and answer the problem under investigation. Further, the researcher identified implications for the research, opportunities for further studies and limitations of research in terms of validity. In addition, the researcher also made recommendations that can help eradicate cases of Missed Nursing Care.

We can conclude that this research is relevant and not biased in presentation of the research problem and findings. The research implications, recommendations and further studies are useful for subsequent development in this field.

Reference List

Aiken, L., Clarke, S., Sloane, D., Sochalski, J., and Silber, J. (2002). Hospital nurse staffing and patient mortality nurse burnout, and job dissatisfaction. JAMA, 288, 1987-1993.

Bettany-Saltikov, J. (2012). How to Do a Systematic Literature Review in Nursing: A Step-By-Step Guide. Leeds: Open University Press.

Kalisch, B. J. (2006). Missed Nursing Care: A Qualitative Study. J Nurs Care Qual, 21(4), 306-313.

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