Stemmer Renate, Bassi Erika, Ezra Sigal, Harvey Clare, Jojo Natasha, Meyer Gabriele, Özsaban Aysel, Paterson Catherine, Shifaza Fathimath, Turner Murray B, Bail Kasia
Catholic University of Applied Sciences, Mainz, Germany.
University of Eastern Piedmont, Novara, Italy.
J Adv Nurs. 2022 Aug;78(8):2290-2303. doi: 10.1111/jan.15286. Epub 2022 May 9.
To investigate the association of unfinished nursing care on nurse outcomes.
Systematic review in line with National Institute for Health and Care Excellence guideline.
CINAHL, the Cochrane Library, Embase, Medline, ProQuest and Scopus databases were searched up until April 2020.
Two independent reviewers conducted each stage of the review process: screening eligibility, quality appraisal using Mixed Methods Appraisal Tool; and data extraction. Narrative synthesis compared measurements and outcomes.
Nine hospital studies were included, and all but one were cross-sectional multicentre studies with a variety of sampling sizes (136-4169 nurses). Studies had low internal validity implying a high risk of bias. There was also a high potential for bias due to non-response. Only one study explicitly sought to examine nurse outcomes as a primary dependent variable, as most included nurse outcomes as mediating variables. Of the available data, unfinished nursing care was associated with: reduced job satisfaction (5/7 studies); burnout (1/3); and intention-to-leave (2/2). No association was found with turnover (2/2).
Unfinished nursing care remains a plausible mediator of negative nurse outcomes, but research is limited to single-country studies and self-reported outcome measures. Given challenges in the sector for nurse satisfaction, recruitment and retention, future research needs to focus on nurse outcomes as a specific aim of inquiry in relation to unfinished nursing care.
Unfinished nursing care has previously been demonstrated to be associated with staffing, education and work environments, with negative associations with patient outcomes (patient satisfaction, medication errors, infections, incidents and readmissions). This study offers new evidence that the impact of unfinished nursing care on nurses is under investigated. Policymakers can prioritize the funding of robust observational studies and quasi-experimental studies with a primary aim to understand the impact of unfinished nursing care on nurse outcomes to better inform health workforce sustainability.
探讨未完成护理工作与护士结局之间的关联。
按照英国国家卫生与临床优化研究所指南进行的系统评价。
检索了CINAHL、Cochrane图书馆、Embase、Medline、ProQuest和Scopus数据库，检索截至2020年4月。
两位独立的评审员进行综述过程的每个阶段：筛选纳入标准、使用混合方法评估工具进行质量评估；以及数据提取。叙述性综合分析比较了测量方法和结局。
纳入了9项医院研究，除1项外均为横断面多中心研究，样本量各不相同（136 - 4169名护士）。研究的内部效度较低，意味着存在较高的偏倚风险。由于无应答，也存在较高的偏倚可能性。只有1项研究明确将护士结局作为主要因变量进行考察，大多数研究将护士结局作为中介变量纳入。在现有数据中，未完成护理工作与以下方面相关：工作满意度降低（5/7项研究）；职业倦怠（1/3）；以及离职意愿（2/2）。未发现与人员流动率相关（2/2）。
未完成护理工作仍然可能是护士负面结局的一个中介因素，但研究仅限于单国家研究和自我报告的结局测量。鉴于该领域在护士满意度、招聘和留用方面面临的挑战，未来研究需要将护士结局作为与未完成护理工作相关的特定研究目标。
先前已证明未完成护理工作与人员配备、教育和工作环境相关，与患者结局存在负相关（患者满意度、用药错误、感染、事件和再入院）。本研究提供了新的证据，表明未完成护理工作对护士的影响尚未得到充分研究。政策制定者可以优先为有力的观察性研究和准实验性研究提供资金，主要目的是了解未完成护理工作对护士结局的影响，以便更好地为卫生人力可持续性提供信息。
