Nursing Care Service, S. Anna University Hospital, Ferrara, Italy.
Nursing Care Service, Campus Bio-Medico University Hospital, Rome, Italy.
J Nurs Manag. 2020 Nov;28(8):2061-2071. doi: 10.1111/jonm.13170. Epub 2020 Oct 17.
To develop and validate a comprehensive tool based on those established in the field capable of reflecting the broader concept of Unfinished Nursing Care.
Different tools have been established in the field of Missed Care, Rationing Care and Tasks Left Undone. However, despite them sharing similar items and all referring to the common concept of Unfinished Nursing Care, no attempts to collapse them in a single tool capable of reflecting current nursing practice, and its increased complexity, have been attempted to date.
A development and validation study was performed in 2017. After developing the instrument starting from the MISSCARE Survey and critically reviewing the other tools available in the field, the Unfinished Nursing Care Survey (UNCS) was subjected to validation. A total of 1977 nurses from 13 acute Italian hospitals were recruited. Acceptability, construct validity (Mokken Scaling, Explorative and Confirmative Factor Analysis), internal consistency, hypothesis testing and criterion validity were assessed according to the COnsensus-based Standards for the selection of health Measurement INstruments guideline.
1,400 (70.8%) nurses participated. The UNCS is composed of part A (=elements of unfinished care) and part B (=reasons for unfinished care) with 21 and 18 items, respectively. The UNCS has showed high acceptability (>90%). Part A has reported a strong scalability (H = .52), thus suggesting a hierarchical structure among the items. The six factors in part B explained a total variance of 64.3% (internal consistency = .806) as confirmed by the Confirmative Factor Analysis.
The comprehensive nature of the UNCS can contribute to the establishment of a common reference measure of the phenomenon worldwide although its psychometric properties require future investigation in different cultural contexts, languages and clinical settings.
Measuring Unfinished Nursing Care provides information on the processes implicated in the development of adverse events before these become visible; moreover, it can increase awareness on nurses' performance and inform appropriate interventions to improve it.
开发并验证一个基于该领域中已建立的工具的综合工具，以反映更广泛的未完成护理概念。
在遗漏护理、配给护理和未完成任务领域已经建立了不同的工具。然而，尽管它们具有相似的项目，并且都指的是未完成护理的共同概念，但迄今为止，尚未尝试将它们合并到一个能够反映当前护理实践及其日益复杂性的单一工具中。
本研究于 2017 年进行了开发和验证。在从 MISSCARE 调查出发开发仪器并批判性地审查该领域其他可用工具后，对未完成护理调查（UNCS）进行了验证。共招募了来自意大利 13 家急性医院的 1977 名护士。根据共识标准选择健康测量工具指南，评估了可接受性、结构有效性（Mokken 缩放、探索性和验证性因素分析）、内部一致性、假设检验和标准有效性。
1400 名（70.8%）护士参与了研究。UNCS 由两部分组成，A 部分（=未完成护理的元素）和 B 部分（=未完成护理的原因），分别有 21 项和 18 项。UNCS 具有较高的可接受性（>90%）。A 部分报告了较强的可扩展性（H=0.52），表明项目之间存在层次结构。B 部分的六个因素解释了总方差的 64.3%（内部一致性=0.806），这也得到了验证性因素分析的证实。
尽管其心理测量特性需要在不同的文化背景、语言和临床环境中进行进一步研究，但 UNCS 的综合性可以为全球范围内建立该现象的共同参考测量标准做出贡献。
测量未完成护理可以提供有关在不良事件变得明显之前涉及的过程的信息；此外，它可以提高对护士绩效的认识，并为改进提供信息。
