Kalisch Beatrice J, Landstrom Gay L, Hinshaw Ada Sue
Nursing Business and Health Systems, School of Nursing, University of Michigan, USA.
J Adv Nurs. 2009 Jul;65(7):1509-17. doi: 10.1111/j.1365-2648.2009.05027.x. Epub 2009 May 9.
This paper is a report of the analysis of the concept of missed nursing care.
According to patient safety literature, missed nursing care is an error of omission. This concept has been conspicuously absent in quality and patient safety literature, with individual aspects of nursing care left undone given only occasional mention.
An 8-step method of concept analysis - select concept, determine purpose, identify uses, define attributes, identify model case, describe related and contrary cases, identify antecedents and consequences and define empirical referents - was used to examine the concept of missed nursing care. The sources for the analysis were identified by systematic searches of the World Wide Web, MEDLINE, CINAHL and reference lists of related journal articles with a timeline of 1970 to April 2008.
Missed nursing care, conceptualized within the Missed Nursing Care Model, is defined as any aspect of required patient care that is omitted (either in part or in whole) or delayed. Various attribute categories reported by nurses in acute care settings contribute to missed nursing care: (1) antecedents that catalyse the need for a decision about priorities; (2) elements of the nursing process and (3) internal perceptions and values of the nurse. Multiple elements in the nursing environment and internal to nurses influence whether needed nursing care is provided.
Missed care as conceptualized within the Missed Care Model is a universal phenomenon. The concept is expected to occur across all cultures and countries, thus being international in scope.
本文是一篇关于对漏护概念分析的报告。
根据患者安全文献，漏护是一种疏忽性差错。这一概念在质量和患者安全文献中明显缺失，护理工作的各个方面未完成的情况只是偶尔被提及。
采用一种八步概念分析法——选择概念、确定目的、识别用途、定义属性、识别典型案例、描述相关和相反案例、识别前因和后果以及定义实证指标——来审视漏护概念。通过对万维网、医学期刊数据库（MEDLINE）、护理及健康领域数据库（CINAHL）进行系统检索以及查阅相关期刊文章的参考文献列表来确定分析的资料来源，时间跨度为1970年至2008年4月。
在漏护模式中概念化的漏护被定义为所需患者护理的任何方面被遗漏（部分或全部）或延迟。急症护理环境中的护士报告的各种属性类别导致了漏护：（1）促使对优先事项做出决策的前因；（2）护理过程的要素；（3）护士的内在认知和价值观。护理环境中的多个因素以及护士自身内在的因素会影响是否提供所需的护理。
在漏护模式中概念化的漏护是一种普遍现象。预计这一概念会在所有文化和国家出现，因此在范围上具有国际性。
