School of Health Professions, ZHAW - Zurich University of Applied Science, Institute of Nursing, Winterthur, Switzerland.
Nursing Science, Faculty of Medicine, Department of Public Health, University of Basel, Basel, Switzerland.
J Adv Nurs. 2021 Feb;77(2):550-564. doi: 10.1111/jan.14596. Epub 2020 Oct 22.
To collate and synthesize published research on interventions developed and tested to prevent or reduce the rates of rationed or missed nursing care in healthcare institutions.
Rationed and missed nursing care has been widely studied, including its predictors and associations with patient and nurse outcomes.
Scoping review.
We searched for eligible studies, published between 1980-2019, in six electronic databases.
Researchers independently screened the abstracts of the retrieved studies using the inclusion and exclusion criteria. The decision of whether or not to include any given study was consensus-based.
The search yielded 1,815 records, of which 13 were included. Three studies reported structural interventions, namely increased nurse staffing and improved nursing teamwork, both resulted in significant reductions in the rates of rationed or missed nursing care. The remaining 10 studies reported on process interventions: four concerned reminders (via technology or designated persons) and seven described interventions to change or optimize the relevant care processes. All 10 process interventions contributed to significant reductions in the rates of missed nursing care.
The results of the scoping review indicate that specific interventions can positively influence the performance of a selected nursing care activity, for example fall prevention. There is no evidence of a global reduction of rationed and missed nursing care through these interventions.
Clinicians, managers and researchers can use the results for adapting and implementing interventions to reduce rationed and missed nursing care.
整理和综合已发表的研究，这些研究旨在开发和测试干预措施，以预防或减少医疗机构中护理服务不足或缺失的发生率。
护理服务不足或缺失已被广泛研究，包括其预测因素以及与患者和护士结局的关联。
范围综述。
我们在六个电子数据库中搜索了 1980 年至 2019 年间发表的符合条件的研究。
研究人员使用纳入和排除标准独立筛选检索研究的摘要。是否纳入任何特定研究的决定是基于共识的。
搜索共产生了 1815 条记录，其中有 13 项研究被纳入。三项研究报告了结构性干预措施，即增加护士人力和改善护理团队合作，这两项措施都显著降低了护理服务不足或缺失的发生率。其余 10 项研究报告了过程干预措施：四项涉及提醒（通过技术或指定人员），七项描述了改变或优化相关护理过程的干预措施。所有 10 项过程干预措施都有助于显著降低护理服务缺失的发生率。
范围综述的结果表明，特定的干预措施可以积极影响选定的护理活动的执行情况，例如预防跌倒。这些干预措施并没有证据表明可以全面减少护理服务不足或缺失的情况。
临床医生、管理人员和研究人员可以利用这些结果来调整和实施干预措施，以减少护理服务不足或缺失的情况。
