Nurses Voice Concerns on Missed Care

Nurses Voice Concerns on Missed Care

Nurses working in hospitals, aged care and New Zealand’s primary health care sector have raised concerns about missed patient care in a survey undertaken by academics at EIT.

Led by Dr Clare Harvey, a team of seven researchers undertook a national study entitled After Hours Nurse Staffing, Work Intensity, and Quality of Care which examines the prevalence of missed nursing care alongside nurses’ perceptions about missed nursing care.

The study forms part of a larger body of research being undertaken by the International Network for the Study of Rationalised Care. A growing body of evidence assembled by INSRNC links rationalised nurse staffing and work organisation practices with adverse outcomes that include occupational stress, illness and injury among nurses, decreased patient satisfaction, more errors and accidents among nurses and increased patient morbidity and mortality.

The New Zealand study supports the international research in finding much of the missed nursing care relates to ineffective methods for determining staffing levels, competing demands that reduce patient care time, and the skill mix of nurses in relation to the severity of patient illness.

Although the international research suggests that omitted nursing care occurs mainly after hours when staffing is typically reduced, the New Zealand study indicates that care is more likely to be missed across all shifts.

The majority of respondents in the EIT study were females aged 45 years or over – in line with a recent New Zealand Nursing Organisation statistic showing that the average age of this country’s nursing workforce is 46.44 years.

The EIT research found indications of two distinct populations within the older nursing workforce. While the majority of respondents were aged 46 plus, 27% had 2-9 years of nursing experience and nearly 31% had over 30 years.

The study also found:
• an apparent correlation between the age of nurses and care that is missed – the older the nurse, the less missed care
• overtime and the working of ‘extra’ shifts are included in normal working allocations
• there is a close correlation between overtime and illness
• staff struggle to cope because they are tired and feel burnt out

Another significant finding in the area of nurses working despite feeling unwell, stressed, or fatigued correlates with a higher incidence of missed nursing care. Nearly 50 percent of respondents feel obligated to colleagues to work despite feeling unwell, and qualitative data also reveals a nursing workforce whose inadequate sick leave entitlements means they have to work.

The researchers say much of nurses’ care work has become invisible in the face of escalating costs and that an international approach is needed to achieve a balance in care that is truly patient-centred, appropriately managed and cost effective.

ENDS

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