Evaluation of nurse‐reported missed care in a post‐anesthesia care unit: A mixed‐methods study

护理部 团队合作 人员配备 Pacu公司 工作量 医学 主题分析 护理管理 人际交往 心理学 定性研究 麻醉 社会心理学 社会科学 社会学 政治学 计算机科学 法学 操作系统
作者
Laura Mun Tze Heng,Darshini Devi Rajasegeran,Siew Hoon Lim
出处
期刊:Journal of Nursing Scholarship [Wiley]
标识
DOI:10.1111/jnu.12975
摘要

Nurse-reported missed care (NRMC) is considered as any significant delay or omission in provision of nursing care.(i) Evaluate the frequency, types, and reasons for NRMC in the Post-anesthesia Care Unit (PACU). (ii) Evaluate associations between nurse demographic and workload factors with NRMC. (iii) Explore nurses' perception of NRMC in the PACU.A cross-sectional study was conducted in the PACU in a tertiary acute care hospital over 3 months. Full-time PACU nurses were conveniently sampled to complete an anonymous survey after their daily shift over different shifts. It contained three sections: (i) nurse demographics; (ii) elements of NRMC; and (iii) reasons for NRMC. Qualitative interviews employed a semi-structured guide to explore perceptions and experiences of NRMC. Descriptive, inferential statistics, and thematic analyses were applied.Sixty-six survey responses were collected. 48.5% of respondents indicated at least one NRMC activity. Activities more clinically sensitive were less missed. Eight nurses were interviewed. Four main themes were identified: (i) communication with patients; (ii) communication and teamwork with colleagues; (iii) dual role of documentation; and (iv) staffing inadequacy. Language barriers made communication challenging. Staff shortage exacerbates workload but effective teamwork and documentation facilitates nursing care.Communication and staffing concerns aggravate NRMC. Teamwork and personal contentment were satisfactory. Nurses' turnover intention may worsen staffing.Timeliness and quality of nursing care is impacted by elements such as manpower, allocation of resources, work processes, and workplace environmental or interpersonal factors such as culture and language fit. Re-evaluation of nursing resources and work processes may assist post-anesthesia care unit nurses in fulfilling their role, decreasing the prevalence of nurse-reported missed care.
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