Ball Jane E, Griffiths Peter, Rafferty Anne Marie, Lindqvist Rikard, Murrells Trevor, Tishelman Carol
National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (NIHR CLAHRC), Wessex, Southampton, UK.
Medical Management Centre (MMC), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet (KI), Stockholm, Sweden.
J Adv Nurs. 2016 Sep;72(9):2086-97. doi: 10.1111/jan.12976. Epub 2016 Apr 20.
To determine factors associated with variation in 'care left undone' (also referred to as 'missed care') by Registered Nurses (RNs) in acute hospital wards in Sweden.
'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 RNs.
Cross-sectional survey to explore the association of RN 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.
A survey of 10,174 RNs working on general medical and surgical wards in 79 acute care hospitals in Sweden (January-March 2010).
Seventy-four per cent 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 RN care for six patients or fewer compared with shifts where they care for 10 or more.
The previously observed relationship between RN staffing and care left undone is confirmed. Reports of care left undone are influenced by RN 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.
确定瑞典急症医院病房中注册护士（RN）“未完成护理”（也称为“漏做护理”）差异的相关因素。
“未完成护理”已被视为调节护士人员配备与患者结局之间关系的一个因素。此前尚未探讨相关背景情况，以确定还有哪些其他因素与注册护士“未完成护理”的差异有关。
采用横断面调查，运用多水平逻辑回归分析，探讨注册护士人员配备以及诸如轮班时间、护理角色和患者病情严重程度/依赖程度等背景因素与“未完成护理”之间的关联。
对瑞典79家急症护理医院普通内科和外科病房的10174名注册护士进行调查（2010年1月至3月）。
74%的护士报告称在上一次轮班时有一些护理工作未完成。轮班时间、患者组合、护士角色、执业环境和人员配备与未完成护理有显著关系。与护理10名或更多患者的轮班相比，护理6名或更少患者的轮班中，护理工作未完成的几率减半。
此前观察到的注册护士人员配备与未完成护理之间的关系得到证实。未完成护理的报告受注册护士角色的影响。辅助工作人员的配备影响不大。需要开展研究以确定这些因素之间如何相互关联，以及未完成护理是否是不良患者结局的一个预测指标。
