Author Affiliations: School of Nursing, Division of Nursing Business and Health Systems, University of Michigan, Ann Arbor (Drs Friese and Kalisch); and School of Nursing, Duke University, Durham, North Carolina (Dr Lee).
Cancer Nurs. 2013 Nov-Dec;36(6):E51-7. doi: 10.1097/NCC.0b013e318275f552.
Missed nursing care influences the quality of hospital care, yet this problem has not been explored in the oncology setting, nor are the correlates of missed nursing care in inpatient oncology settings understood.
We examined the frequency of missed care in oncology units, differences in missed care between oncology and non-oncology units, and the relationship between unit staffing and missed care.
We performed secondary analysis of survey data collected in 2008 to 2009 across 9 hospitals. The MISSCARE Survey was administered to nurses and medical assistants employed in 62 units (n = 2318). Descriptive statistics and linear regression were used to examine the frequency of missed care, differences between oncology (n = 12) and non-oncology units (n=50), and the relationship between unit staffing and missed care.
Oncology nursing unit personnel reported ambulation, care conference attendance, and mouth care as most frequently missed. Oncology units had significantly lower missed care than did non-oncology units (P < .05). Higher patient assignments were associated with an increase in reported missed care (P < .05).
Missed care is a problem shared by inpatient oncology and non-oncology units. Missed ambulation and mouth care are worrisome, given their importance to oncology patients. Suboptimal staffing increases missed care.
These data motivate quality improvement and evidence-based management. Clinicians can strategize to ensure patients receive adequate ambulation and mouth care. Managers can use our findings to support the importance of stable nurse staffing to reduce untoward patient outcomes.
护理缺失会影响医院护理质量，但这一问题尚未在肿瘤学领域得到探讨，也不了解住院肿瘤学环境中护理缺失的相关因素。
我们研究了肿瘤科病房护理缺失的频率、肿瘤科病房与非肿瘤科病房之间护理缺失的差异，以及单位人员配备与护理缺失的关系。
我们对 2008 年至 2009 年在 9 家医院收集的调查数据进行了二次分析。MISSCARE 调查对在 62 个科室（n=2318）工作的护士和医疗助理进行了评估。使用描述性统计和线性回归来检查护理缺失的频率、肿瘤科（n=12）和非肿瘤科病房（n=50）之间的差异，以及单位人员配备与护理缺失的关系。
肿瘤科护理单元人员报告最常缺失的是活动、护理会议出席和口腔护理。肿瘤科病房的护理缺失明显低于非肿瘤科病房（P<.05）。较高的患者分配与报告的护理缺失增加相关（P<.05）。
护理缺失是住院肿瘤学和非肿瘤学病房共有的问题。缺失活动和口腔护理令人担忧，因为它们对肿瘤患者很重要。人员配备不足会增加护理缺失。
这些数据为质量改进和循证管理提供了动力。临床医生可以制定策略以确保患者接受充分的活动和口腔护理。管理人员可以利用我们的发现来支持稳定护士人员配备的重要性，以减少不良的患者结局。
