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A cross sectional study of ‘care left undone’ on nursing shifts in hospitals

A cross sectional study of ‘care left undone’ on nursing shifts in hospitals
A cross sectional study of ‘care left undone’ on nursing shifts in hospitals
Aims: To determine factors associated with variation in ‘care left undone’ (also referred to as “missed care”) by registered nurses in acute hospital wards in Sweden.

Background: ‘Care left undone’ has been examined as a factor mediating the relationship between nurse staffing and patient outcomes. The context has not previously been explored to determine what other factors are associated with variation in ‘care left undone’ by registered nurses.

Design: Cross-sectional survey to explore the association of registered nurse staffing and contextual factors such as time of shift, nursing role and patient acuity / dependency on ‘care left undone’ was examined using multi-level logistic regression.

Methods: A survey of 10,174 registered nurse working on general medical and surgical wards in 79 acute care hospitals in Sweden (Jan-March 2010).
Results: 74% of nurses reported some care was left undone on their last shift. The time of shift, patient mix, nurses’ role, practice environment, and staffing have a significant relationship with care left undone. The odds of care being left undone is halved on shifts where registered nurse care for 6 patients or fewer compared with shifts where they care for 10 or more.

Conclusion: The previously observed relationship between registered nurse staffing and care left undone is confirmed. Reports of care left undone is influenced by registered nurse roles. Support worker staffing has little effect. Research is needed to identify how these factors relate to one another and whether care left undone is a predictor of adverse patient outcomes.
nurse staffing, nursing workload, practice environment, workforce planning, safe staffing levels, missed care, care left undone
0309-2402
1-17
Ball, J.
85ac7d7a-b21e-42fd-858b-78d263c559c1
Griffiths, P.
ac7afec1-7d72-4b83-b016-3a43e245265b
Rafferty, A.
edb0de2c-bd55-4a8e-8e00-dedad49b4a95
Lindqvist, R.
62e7bb8e-ab95-4892-8a13-1c52f01f884b
Murrells, T.
5968b6c0-e5ec-46b5-8dd3-57a747573b99
Tishelman, C.
3147785b-d8a6-4e53-9c99-3d13093f713c
Ball, J.
85ac7d7a-b21e-42fd-858b-78d263c559c1
Griffiths, P.
ac7afec1-7d72-4b83-b016-3a43e245265b
Rafferty, A.
edb0de2c-bd55-4a8e-8e00-dedad49b4a95
Lindqvist, R.
62e7bb8e-ab95-4892-8a13-1c52f01f884b
Murrells, T.
5968b6c0-e5ec-46b5-8dd3-57a747573b99
Tishelman, C.
3147785b-d8a6-4e53-9c99-3d13093f713c

Ball, J., Griffiths, P., Rafferty, A., Lindqvist, R., Murrells, T. and Tishelman, C. (2016) A cross sectional study of ‘care left undone’ on nursing shifts in hospitals. Journal of Advanced Nursing, 1-17. (doi:10.1111/jan.12976).

Record type: Article

Abstract

Aims: To determine factors associated with variation in ‘care left undone’ (also referred to as “missed care”) by registered nurses in acute hospital wards in Sweden.

Background: ‘Care left undone’ has been examined as a factor mediating the relationship between nurse staffing and patient outcomes. The context has not previously been explored to determine what other factors are associated with variation in ‘care left undone’ by registered nurses.

Design: Cross-sectional survey to explore the association of registered nurse staffing and contextual factors such as time of shift, nursing role and patient acuity / dependency on ‘care left undone’ was examined using multi-level logistic regression.

Methods: A survey of 10,174 registered nurse working on general medical and surgical wards in 79 acute care hospitals in Sweden (Jan-March 2010).
Results: 74% of nurses reported some care was left undone on their last shift. The time of shift, patient mix, nurses’ role, practice environment, and staffing have a significant relationship with care left undone. The odds of care being left undone is halved on shifts where registered nurse care for 6 patients or fewer compared with shifts where they care for 10 or more.

Conclusion: The previously observed relationship between registered nurse staffing and care left undone is confirmed. Reports of care left undone is influenced by registered nurse roles. Support worker staffing has little effect. Research is needed to identify how these factors relate to one another and whether care left undone is a predictor of adverse patient outcomes.

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More information

Accepted/In Press date: 24 February 2016
e-pub ahead of print date: 20 April 2016
Keywords: nurse staffing, nursing workload, practice environment, workforce planning, safe staffing levels, missed care, care left undone
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 389647
URI: https://eprints.soton.ac.uk/id/eprint/389647
ISSN: 0309-2402
PURE UUID: a1832767-c3db-46d0-87f2-b24831c4805e
ORCID for J. Ball: ORCID iD orcid.org/0000-0002-8655-2994
ORCID for P. Griffiths: ORCID iD orcid.org/0000-0003-2439-2857

Catalogue record

Date deposited: 11 Mar 2016 14:49
Last modified: 06 Jun 2018 12:32

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Contributors

Author: J. Ball ORCID iD
Author: P. Griffiths ORCID iD
Author: A. Rafferty
Author: R. Lindqvist
Author: T. Murrells
Author: C. Tishelman

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