Sist Luisa, Chiappinotto Stefania, Messina Rossella, Rucci Paola, Palese Alvisa
Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, 40123 Bologna, Italy.
IRCCS Azienda Ospedaliero, Universitaria di Bologna, 40138 Bologna, Italy.
Nurs Rep. 2024 Mar 27;14(2):753-766. doi: 10.3390/nursrep14020058.
The concept of unfinished nursing care (UNC) describes nursing interventions required by patients and families that nurses postpone or omit. UNC reasons have been documented; however, no studies have summarised the underlying factors triggering the UNC during the pandemic. Therefore, the aim was to synthesise the available studies exploring factors affecting UNC during a pandemic. We conducted an integrative review following Whittemore and Knafl's framework according to the Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Scopus databases were searched for primary studies that collected data from 1 January 2020 to 1 May 2023. Both qualitative and quantitative studies assessing the reasons for UNC were eligible and evaluated in their quality using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Four studies were included-three qualitative and one cross-sectional. The reasons for UNC have been documented at the following levels: (a) system (e.g., new healthcare system priorities); (b) unit (e.g., ineffective work processes); (c) nurse management (e.g., inadequate nurse manager's leadership); (d) nurse (e.g., nurses' attitudes, competences, performances); and (e) patient (increased demand for care). The reasons for UNC during the COVID-19 pandemic are different to those documented in the pre-pandemic times and reflect a pre-existing frailty of the National Health Service towards nursing care.
未完成护理(UNC)的概念描述了护士推迟或遗漏的患者及家属所需的护理干预措施。UNC的原因已有记录;然而,尚无研究总结疫情期间引发UNC的潜在因素。因此,本研究旨在综合现有研究,探讨疫情期间影响UNC的因素。我们按照Whittemore和Knafl的框架,依据系统评价和Meta分析报告规范(PRISMA)指南进行了一项综合评价。在PubMed、护理及相关健康文献累积索引数据库(CINAHL)和Scopus数据库中检索了2020年1月1日至2023年5月1日期间收集数据的原始研究。评估UNC原因的定性和定量研究均符合要求,并使用批判性评价技能计划和混合方法评价工具对其质量进行评估。共纳入四项研究,其中三项为定性研究,一项为横断面研究。UNC的原因在以下层面有记录:(a)系统层面(如医疗系统新的优先事项);(b)科室层面(如无效的工作流程);(c)护士管理层面(如护士长领导力不足);(d)护士层面(如护士的态度、能力、表现);以及(e)患者层面(护理需求增加)。新冠疫情期间UNC的原因与疫情前记录的原因不同,反映出国民医疗服务体系在护理方面预先存在的脆弱性。