Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey.
Department of Medicine, University of Udine, Udine, Italy.
BMC Health Serv Res. 2024 Mar 19;24(1):352. doi: 10.1186/s12913-024-10708-7.
Unfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically review the occurrence of, reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic.
Systematic review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing.
Twenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care.
Two continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.
在全球医疗保健环境中，未完成的护理工作越来越受到关注。鉴于其负面后果，持续评估那些通常被推迟或遗漏的护理干预措施以及潜在的原因和后果至关重要。全球 COVID-19 大流行使得医疗机构难以维持其可持续性和护理连续性，这也影响了未完成的护理工作现象。然而，迄今为止，没有对 COVID-19 大流行期间进行的研究进行总结。本研究的主要目的是系统地审查 COVID-19 大流行期间医疗保健环境中患者未完成的护理工作的发生、原因和后果。
在 PROSPERO（CRD42023422871）中进行系统审查。使用了首选报告项目的系统审查和荟萃分析声明指南以及乔安娜布里格斯研究所横断面研究的批判性评估工具。从 2020 年 3 月到 2023 年 5 月，使用该领域确定的关键词，如护理疏忽、未完成的护理工作或隐含配给，在 MEDLINE-PubMed、累积索引到护理和相关健康文献以及 Scopus 中进行了搜索。
共纳入并评估了 25 项主要在欧洲和亚洲国家进行的研究，这些研究具有良好的方法学质量。使用了以下工具：MISSCARE 调查（= 14）；巴塞尔护理配给程度（= 1），也有修订版（= 2）和针对疗养院（= 2）；感知隐含护理配给（= 4）；重症监护病房遗漏的护理工作（= 1）；以及未完成的护理工作调查（= 1）。在一些国家，出现的未完成护理工作干预措施的顺序与大流行前的数据基本一致（例如，口腔护理、走动）。然而，在国家和国家之间出现了一些有趣的变化。相反，劳动力资源和接近护士情绪状态和幸福感的原因被一致提到是大流行期间影响未完成护理工作的最重要因素。没有研究调查未完成护理工作的后果。
在大流行期间，两个大洲主导了该领域的研究：已经在该领域有良好研究基础的欧洲，以及该领域有大量新研究的亚洲。虽然欧洲的未完成护理工作发生似乎基于预先确定的模式（例如，基本需求），但亚洲国家出现了新的模式。在这些原因中，发现结果的一致性与大流行前记录的结果一致。
