Rory Meyers College of Nursing, New York University, United States of America; Department of Family Health Care Nursing, University of California San Francisco, United States of America.
Mercy Hospital, Saint Louis, United States of America.
Appl Nurs Res. 2022 Feb;63:151516. doi: 10.1016/j.apnr.2021.151516. Epub 2021 Oct 19.
: To evaluate the psychometric characteristics of the Perinatal Missed Care Survey and assess the prevalence of nurse-reported missed care during labor and birth.
: Nursing care during labor and birth differs from other nursing care. Empirical evidence is scant regarding nursing quality and missed nursing care during labor and birth, which are important aspects of quality in maternity care.
: We conducted exploratory and confirmatory factor analysis on a previously developed perinatal missed nursing care instrument using data from 3,466 registered nurses. Measures included missed nursing care, reasons for missed nursing care, and demographic characteristics. All birth hospitals in each of 37 states were invited to distribute surveys electronically via email to their labor and delivery RN staff. The overall response rate from 277 hospitals that facilitated the survey was 35%.
: Some missed care was reported for each of 25 missed care items. Labor support, intake and output, patient teaching, timely documentation, timely medication administration, and thorough review of prenatal records were missed at least occasionally by >50% respondents. Labor resources (83%), material resources (77%), and communication (60%) were reported reasons for missed nursing care. Exploratory factor analysis aligned with previous testing. Confirmatory factor analysis demonstrated good model fit.
: The Perinatal Missed Care Survey demonstrates good validity and reliability as a measure of missed nursing care during labor and birth. Our findings suggest missed nursing care during labor and birth is prevalent and occurs in aspects of care that could contribute to patient harm when missed.
评估围产期护理缺失调查的心理计量学特征，并评估分娩期间护士报告的护理缺失的发生率。
分娩期间的护理与其他护理不同。关于分娩期间的护理质量和护理缺失的实证证据很少，而这是产妇护理质量的重要方面。
我们使用来自 3466 名注册护士的数据，对先前开发的围产期护理缺失工具进行了探索性和验证性因子分析。测量包括护理缺失、护理缺失的原因以及人口统计学特征。邀请 37 个州的所有分娩医院通过电子邮件向其分娩和分娩的注册护士工作人员电子分发调查。在促成调查的 277 家医院中，总体回复率为 35%。
对于 25 项缺失护理项目中的每一项，都报告了一些缺失的护理。分娩支持、摄入和输出、患者教育、及时记录、及时用药以及对产前记录的彻底审查至少偶尔被> 50%的受访者遗漏。劳动力资源（83%）、物质资源（77%）和沟通（60%）被报告为护理缺失的原因。探索性因子分析与之前的测试一致。验证性因子分析表明模型拟合良好。
围产期护理缺失调查作为衡量分娩期间护理缺失的一种有效且可靠的方法。我们的研究结果表明，分娩期间的护理缺失很普遍，并且发生在可能导致患者伤害的护理方面。
