Kalisch Beatrice J, Landstrom Gay, Williams Reg Arthur
Nursing Business and Health Systems and University of Michigan, Ann Arbor, MI 48109, USA.
Nurs Outlook. 2009 Jan-Feb;57(1):3-9. doi: 10.1016/j.outlook.2008.05.007.
This study examines what and why nursing care is missed. A sample of 459 nurses in 3 hospitals completed the Missed Nursing Care (MISSCARE) Survey. Assessment was reported to be missed by 44% of respondents while interventions, basic care, and planning were reported to be missed by > 70% of the survey respondents. Reasons for missed care were labor resources (85%), material resources (56%), and communication (38%). A comparison of the hospitals showed consistency across all 3 hospitals. Associate degree nurses reported more missed care than baccalaureate-prepared and diploma-educated nurses. The results of this study lead to the conclusion that a large proportion of all hospitalized patients are being placed in jeopardy because of missed nursing care or errors of omission. Furthermore, changes in Center for Medicare and Medicaid Services (CMS) regulations which will eliminate payment for acute care services when any one of a common set of complications occurs, such as pressure ulcers and patient falls, point to serious cost implications for hospitals.
本研究调查了护理缺失的内容及原因。来自3家医院的459名护士参与了护理缺失（MISSCARE）调查。44%的受访者表示评估环节存在缺失，而超过70%的受访者称干预措施、基础护理和护理计划存在缺失。护理缺失的原因包括劳动力资源（85%）、物资资源（56%）和沟通问题（38%）。对这3家医院的比较显示，所有3家医院情况一致。副学士学位护士报告的护理缺失情况比学士学位护士和文凭护士更多。本研究结果得出结论，由于护理缺失或疏忽失误，大量住院患者面临风险。此外，医疗保险和医疗补助服务中心（CMS）的法规变化表明，当出现一系列常见并发症（如压疮和患者跌倒）中的任何一种时，将不再支付急性护理服务费用，这对医院意味着严重的成本影响。
