Provost Josiane, Gosselin Émilie, Rochefort Christian M
Health Sciences Research Program, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada.
Nursing, Université de Sherbrooke, Sherbrooke, Canada.
J Adv Nurs. 2025 May 1. doi: 10.1111/jan.17017.
AIM(S): To analyse the dimensions of the omission of nursing care in emergency departments, including its attributes, antecedents, and consequences, using Walker & Avant's concept analysis method.
Methods: Walker and Avant's eight-step method defined attributes, antecedents, and consequences of the omission of nursing care in emergency departments.
A comprehensive literature review was conducted using CINAHL, MEDLINE, Embase, Health Management Database, and Cochrane Library, covering publications from 2001 to 2024. The search was conducted in August 2024.
Key attributes were delayed, incomplete, or interrupted care, mostly due to insufficient staffing or unpredictable patient volumes. Antecedents included high workloads, inadequate skill mixes, and understaffing. Consequences were increased patient morbidity and mortality, nurse burnout, and job dissatisfaction. A research gap exists in paediatric-specific measurement tools.
Identifying dimensions of omitted nursing care in emergency departments informs interventions to improve patient safety and care quality. Developing paediatric-specific measurement tools is essential.
IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: The findings emphasise the need for improved staffing and resource allocation policies, reducing risks to patients and enhancing nurse satisfaction.
This study addressed the gap in understanding omitted nursing care specifically in emergency departments. Findings highlight systemic issues impacting patient outcomes and nurse well-being. The results will guide organisational improvements and future research globally.
This study adhered to EQUATOR guidelines, following Walker and Avant's method for concept analysis.
This study did not include patient or public involvement.
This study underscores the critical impact of the omission of nursing care (ONC) in emergency departments (EDs) on patient safety, nurse well-being, and healthcare efficiency. ONC contributes to increased morbidity, mortality, and adverse events, highlighting the urgent need for improved staffing models and resource allocation. Training programmes should equip emergency nurses with prioritisation strategies to mitigate care omissions. Policymakers must recognise ONC as a key quality indicator, ensuring adequate workforce support. Additionally, this study identifies a gap in measuring ONC in paediatric EDs, calling for the development of tailored assessment tools and further research on intervention strategies.
运用沃克和阿凡特的概念分析法，分析急诊科护理缺失的维度，包括其属性、 antecedents和后果。
方法：沃克和阿凡特的八步法界定了急诊科护理缺失的属性、 antecedents和后果。
使用CINAHL、MEDLINE、Embase、健康管理数据库和考科蓝图书馆进行全面的文献综述，涵盖2001年至2024年的出版物。检索于2024年8月进行。
关键属性为延迟、不完整或中断的护理，主要原因是人员配备不足或患者数量不可预测。 Antecedents包括高工作量、技能组合不足和人员配备不足。后果是患者发病率和死亡率增加、护士倦怠和工作不满。儿科专用测量工具存在研究空白。
识别急诊科护理缺失的维度有助于采取干预措施，以提高患者安全和护理质量。开发儿科专用测量工具至关重要。
对专业和/或患者护理的影响：研究结果强调需要改进人员配备和资源分配政策，降低患者风险并提高护士满意度。
本研究填补了专门针对急诊科护理缺失理解方面的空白。研究结果突出了影响患者结局和护士福祉的系统性问题。研究结果将指导全球范围内的组织改进和未来研究。
本研究遵循赤道准则，采用沃克和阿凡特的概念分析方法。
本研究未纳入患者或公众参与。
本研究强调急诊科护理缺失（ONC）对患者安全、护士福祉和医疗效率的关键影响。ONC导致发病率、死亡率和不良事件增加，凸显了改进人员配备模式和资源分配的迫切需求。培训计划应使急诊护士具备优先排序策略，以减少护理缺失。政策制定者必须将ONC视为关键的质量指标，确保有足够的劳动力支持。此外，本研究确定了儿科急诊科测量ONC方面的空白，呼吁开发量身定制的评估工具，并进一步研究干预策略。 （注：“antecedents”直译为“先行因素”，这里意译为“前因”；“后果”即英文中的“consequences” ）
