Gong Fengxiang, Mei YuChen, Wu Mengying, Tang Chao
College of Nursing, ShaoYang University, Shaoyang, China.
Int Nurs Rev. 2025 Mar;72(1):e13096. doi: 10.1111/inr.13096.
While numerous studies have quantified the prevalence of reasons for missed care, a comprehensive synthesis of evidence across various health systems remains lacking.
To estimate the pooled prevalence of the reasons reported by nurses for missed care, using data from the MISSCARE surveys.
Missed nursing care, which refers to any aspect of essential patient care that is omitted or delayed, presents substantial risks to patient safety and the quality of care.
Four databases (PubMed, Web of Science, Embase, and Scopus) were searched, without language restrictions. Study quality was assessed using Joanna Briggs Institute's critical appraisal tool. A random-effects meta-analysis was used to calculate prevalence estimates and evaluate heterogeneity via prediction intervals. Subgroup analyses were conducted to assess potential sources of heterogeneities. Time trends were estimated using linear regression modeling.
Twenty-eight studies (2011-2024) totaling 20768 nurses from 121 hospitals from 14 countries were included. The raw prevalence of missed care ranged from 6.8% to 98.1%, with a median of 56.4% (IQR: 41.0-75.4). The most frequently reported reasons were "unexpected rise in patient volume and/or acuity on the unit" (78.1%; 95% confidence intervals (CI) 71.5-54.1), "inadequate number of staff" (76.5%; 95% CI, 68.7-83.5), and "urgent patient situation" (73.5%; 95% CI, 66.6-79.9). Most of the investigated reasons for missed nursing care showed no significant changes over time.
This meta-analysis provides valuable insights that can inform interventions and policies aimed at mitigating missed nursing care, ultimately improving patient safety and healthcare outcomes.
This study underscores the global prevalence reasons for missed nursing care. The findings call for comprehensive strategies to address this crucial challenge, regardless of geographic region and economic status of countries. However, special attention should be given to non-university hospitals and hospitals with specific demographic characteristics of nurses.
尽管众多研究已对错过护理的原因发生率进行了量化，但仍缺乏对不同卫生系统证据的全面综合分析。
利用“错过护理情况调查”（MISSCARE surveys）的数据，估算护士报告的错过护理原因的合并发生率。
错过护理是指基本患者护理的任何方面被遗漏或延迟，这对患者安全和护理质量构成重大风险。
检索了四个数据库（PubMed、科学网、Embase和Scopus），无语言限制。使用乔安娜·布里格斯研究所的批判性评价工具评估研究质量。采用随机效应荟萃分析来计算发生率估计值，并通过预测区间评估异质性。进行亚组分析以评估异质性的潜在来源。使用线性回归模型估计时间趋势。
纳入了28项研究（2011 - 2024年），共涉及来自14个国家121家医院的20768名护士。错过护理的原始发生率范围为6.8%至98.1%，中位数为56.4%（四分位间距：41.0 - 75.4）。最常报告的原因是“科室患者数量和/或病情严重程度意外增加”（78.1%；95%置信区间[CI] 71.5 - 54.1）、“工作人员数量不足”（76.5%；95% CI，68.7 - 83.5）以及“患者紧急情况”（73.5%；95% CI，66.6 - 79.9）。大多数调查的错过护理原因随时间未显示出显著变化。
这项荟萃分析提供了有价值的见解，可为旨在减少错过护理情况的干预措施和政策提供参考，最终改善患者安全和医疗保健结果。
本研究强调了全球范围内错过护理的普遍原因。研究结果呼吁采取全面战略来应对这一关键挑战，无论国家的地理区域和经济状况如何。然而，应特别关注非大学附属医院以及具有特定护士人口统计学特征的医院。
