Research Article
BibTex RIS Cite

Bir üniversite hastanesinde karşılanmayan hemşirelik bakım gereksinimi miktarı ve nedenleri

Year 2019, Volume: 44 Issue: 4, 1226 - 1236, 29.12.2019
https://doi.org/10.17826/cumj.509488

Abstract

Amaç: Çalışmanın amacı, bir üniversite hastanesinde karşılanmayan hemşirelik bakım gereksinimi miktarı ve nedenlerini değerlendirmektir. 

Gereç ve Yöntem: Tanımlayıcı nitelikteki çalışma, Mart-Aralık 2017 tarihleri arasında bir üniversite hastanesinde çalışan ve çalışmaya katılmayı gönüllük esasına dayalı olarak kabul eden 94 hemşire ile gerçekleştirilmiştir. Veriler, araştırmacılar tarafından literatür doğrultusunda oluşturulan anket formu ve Karşılanmayan Hemşirelik Bakım Gereksinimi Ölçeği ile toplanmıştır. 

Bulgular: Sıklıkla karşılanmayan hemşirelik bakımlarının, hastayı günde üç kez veya gerektiği kadar ayağa kaldırma/dolaştırma (%41), düzenlenen disiplinler arası bakım konferanslarına katılma (%41),  hastaya ve/veya hasta yakınlarına duygusal destek verilmesi (%40) ve taburcu olan hastanın kullanacağı ilaçların dozu, alınma zamanı ve yan etkilerinin hasta ile birlikte gözden geçirilmesi (%33) olduğu görülmektedir. Çalışılan birim  ve karşılanmayan hemşirelik bakım gereksinimi kavramı hakkında bilgi sahibi olma durumu  ile karşılanmayan hemşirelik bakım gereksinimleri arasında; hemşire sayısı yeterliliğini algılama ile karşılanmayan hemşirelik bakım hizmetlerinin nedenleri arasında anlamlı bir ilişki olduğu  bulunmuştur.

Sonuç: Karşılanmayan hemşirelik bakımı, hemşirelik bakımının kalitesini olumsuz etkilemekte ve hasta güvenliğini riske sokmaktadır. Kavramın yapılacak çalışmalarla yakından ele alınması ve bu doğrultuda uygun protokollerin geliştirilmesi önerilmektedir.


References

  • Dinç L. Bakım kavramı ve ahlaki boyutu. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2010;17(2):74-82. Available from: http://dergipark.gov.tr/download/article-file/88519.
  • Cho SH, Kim YS, Yeon KN, You SJ, Lee ID. Effects of ıncreasing nurse staffing on missed nursing care. Int Nurs Rev. 2015;62(2):267-74. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/inr.12173.
  • Kalisch BJ, Terzioglu F, Duygulu S. The MISSCARE Survey-Turkish: Psychometric properties and findings. Nurs Econ. 2012;30(1):29-37. Available from: http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=88a68879-0297-4913-bd4f-b10a6598a63c%40sessionmgr4009.
  • Kalisch BJ, Xie B. Errors of omission missed nursing care. West J Nurs Res. 2014;36(7):875-90. doi: 10.1177/0193945914531859.
  • Kalisch BJ, Lee KH. The impact of teamwork on missed nursing care. Nurs Outlook. 2010;58(5):233-41. doi:10.1016/j.outlook.2010.06.004.
  • Donabedian A. The quality of care: how can it be assessed? Jama. 1988;260(12): 1743-48.
  • Blackman I, Henderson J, Willis E, Hamilton P, Toffoli L, Verrall C, et al. Factors influencing why nursing care is missed. J Clin Nurs. 2015;24(1-2):47-56. doi: 10.1111/jocn.12688.
  • Henderson J, Willis E, Blackman I, Toffoli L, Verrall C. Causes of missed nursing care: qualitative responses to a survey of australian nurses. Labour & Industry: A Journal of the Social and Economic Relations of Work. 2016;26(4):281-97.
  • Jangland E, Teodorsson T, Molander K, Muntlin Athlin Å. Inadequate environment, resources and values lead to missed nursing care: A focused ethnographic study on the surgical ward using the fundamentals of care framework. J Clin Nurs. 2018;27(11-12):2311-21. doi: 10.1111/jocn.14095.
  • Kalisch BJ, Tschannen D, Lee KH. Missed nursing care, staffing, and patient falls. J Nurs Care Qual. 2012;27(1):6-12. doi: 10.1097/NCQ.0b013e318225aa23.
  • Kalisch BJ, Tschannen D, Lee KH. Do staffing levels predict missed nursing care? Int J Qual Health Care. 2011;23(3):302-8. doi: 10.1093/intqhc/mzr009.
  • Kalisch BJ, Landstrom G, Williams RA. Missed nursing care: Errors of omission. Nurs Outlook. 2009;57(1):3-9. doi:10.1016/j.outlook.2008.05.007.
  • Ausserhofer D, Zander B, Busse R, Schubert M, De Geest S, Rafferty AM, et al. Prevalence, patterns and predictors of nursing care left undone ın european hospitals: results from the multicountry cross-sectional rn4cast study. BMJ Quality & Safety. 2014;23(2):126-35. doi:10.1136/bmjqs-2013-002318.
  • Kalisch BJ, Williams RA. Development and psychometric testing of a tool to measure missed nursing care. J Nurs Adm. 2009;39(5):211-19. doi: 10.1097/NNA.0b013e3181a23cf5.
  • Palese A, Ambrosi E, Prosperi L, Guarnier A, Barelli P, Zambiasi P, et al. Missed nursing care and predicting factors in the Italian medical care setting. Intern Emerg Med. 2015;10(6):693-702. doi:10.1007/s11739-015-1232-6.
  • Tubbs-Cooley HL, Gurses AP. Missed nursing care: understanding and ımproving nursing care quality in pediatrics. Hosp Pediatr. 2017;7(7):424-26. doi:https://doi.org/10.1542/hpeds.2017-0083.
  • Ball JE, Murrells T, Rafferty AM, Morrow E, Griffiths P.Care left undone’during nursing shifts: associations with workload and perceived quality of care. BMJ Quality & Safety. 2014;23(2):116-25. doi:10.1136/bmjqs-2012-001767.
  • Spetz J, Harless DW, Herrera CN, Mark BA. Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care. Med Care Res Rev. 2013;70(4):380–99. doi: 10.1177/1077558713475715.
  • Frith KH, Anderson EF, Caspers B, Tseng F, Sanford K, Hoyt NG, Moore K. Effects of nurse staffing on hospital-acquired conditions and length of stay in community hospitals. Qual Manag Health Care. 2010;19(2):147–55. doi: 10.1097/QMH.0b013e3181dafe3f.
  • O’Brien-Pallas L, Li XM, Wang S, Meyer RM, Thomson D. Evaluation of a patient care delivery model: System outcomes in acute cardiac care. Can J Nurs Res 2010;42(4):98–120.
  • Weiss ME, Yakusheva O, Bobay KL. Quality and cost analysis of nurse staffing, discharge preparation and postdischarge utilization. Health Serv Res. 2011;46(5);1473–94. doi: 10.1111/j.1475-6773.2011.01267.x.
  • Lucero RJ, Lake ET, Aiken LH. Nursing care quality and adverse events in US hospitals. J Clin Nurs. 2010;19(15–16):2185–95. doi: 10.1111/j.1365-2702.2010.03250.x.
  • Schubert M, Clarke SP, Glass TR, Schaffert-Witvliet B, De Geest S. Identifying thresholds for relationships between impacts of rationing of nursing care and nurse- and patient-reported outcomes in Swiss hospitals: A correlational study. Int J Nurs Stud. 2009;46(7):884–93. doi:10.1016/j.ijnurstu.2008.10.008.
  • Stimpfel AW, Sloane DM, Aiken LH. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs. 2012;31(11):2501-9. doi: 10.1377/hlthaff.2011.1377.
  • Gutierrez KM. Critical care nurses' perceptions of and responses to moral distress. Dimens Crit Care Nurs. 2005;24(5):229-41.
  • Duffy JR, Culp S, Padrutt T. Description and factors associated with missed nursing care in an acute care community hospital. J Nurs Adm. 2018;48(7/8):361-67. doi: 10.1097/NNA.0000000000000630.
  • Kalisch B, Tschannen D, Lee H, Friese C. Hospital variation in missed nursing care. Am J Med Qual. 2011;26(4):291-99. doi: 10.1177/1062860610395929.
  • Sepulveda-Pacsi AL, Soderman M, Kertesz L. Nurses' perceptions of their knowledge and barriers to ambulating hospitalized patients in acute settings. Appl Nurs Res. 2016;32:117-121. http://dx.doi.org/10.1016/j.apnr.2016.06.001.
  • Doherty-King B, Bowers B. Attributing the responsibility for ambulating patients: A qualitative study. Int J Nurs Stud. 2013;50(9):1240–46.
  • Winters R, Neville S. Registered nurse perspectives on delayed or missed nursing cares in a New Zealand Hospital. Nurs Prax N Z. 2012;28(1):19-28.
  • Cho SH, Yun SC. Bed-to-nurse ratios, provision of basic nursing care, and in-hospital and 30-day mortality among acute stroke patients admitted to an intensive care unit: Cross-sectional analysis of survey and administrative data. Int J Nurs Stud. 2009;46(8):1092-101.
  • Castner J, Wu YWB, Dean-Baar S. Multi-level model of missed nursing care in the context of hospital merger. West J Nurs Res. 2015;37(4):441-61.
  • Griffiths P, Ball J, Drennan J, Dall’Ora C, Jones J, Maruotti A, et al. Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the national ınstitute for health and care excellence safe staffing guideline development. Int J Nurs Stud. 2016;63:213-25.
  • Needleman J, Buerhaus P, Pankratz VS, Leibson CL, Stevens SR, Harris M. Nurse staffing and inpatient hospital mortality. New England Journal of Medicine. 2011;364(11):1037-45.
  • Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care in hospitals. New England Journal of Medicine. 2002;346(22):1715-22.

Evaluation of nurses in a university hospital for the amount and reasons of unmet nursing need

Year 2019, Volume: 44 Issue: 4, 1226 - 1236, 29.12.2019
https://doi.org/10.17826/cumj.509488

Abstract

Purpose: This study evaluates the amount and causes of unmet nursing care needs at a university hospital.

Materials and Methods: This descriptive study was conducted between March and December 2017 with 94 university hospital nurses who participated voluntarily. Data were collected using a questionnaire form and the “Unmet Nursing Care Needs Scale”, which was created in accordance with the literature by the researchers. 

Results: The unmet nursing care needs were getting up or walking patients three times a day or as needed (41%), participating in multidisciplinary care conferences (41%), providing patient/patient relatives with emotional support (40%) and reviewing the dosage, taking time and side effects of the drugs the patient will use with the patient (33%). There was a significant relationship between having information about the unit and the concept of unmet nursing care needs, and perceiving the adequacy of number of nurses and the causes of unmet nursing care needs.

Conclusion: Unmet nursing care needs affect the quality of nursing care and risk the safety of patients. This concept should be studied carefully by future studies, and proper protocols should be enhanced accordingly.


References

  • Dinç L. Bakım kavramı ve ahlaki boyutu. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi. 2010;17(2):74-82. Available from: http://dergipark.gov.tr/download/article-file/88519.
  • Cho SH, Kim YS, Yeon KN, You SJ, Lee ID. Effects of ıncreasing nurse staffing on missed nursing care. Int Nurs Rev. 2015;62(2):267-74. Available from: https://onlinelibrary.wiley.com/doi/pdf/10.1111/inr.12173.
  • Kalisch BJ, Terzioglu F, Duygulu S. The MISSCARE Survey-Turkish: Psychometric properties and findings. Nurs Econ. 2012;30(1):29-37. Available from: http://eds.a.ebscohost.com/eds/pdfviewer/pdfviewer?vid=0&sid=88a68879-0297-4913-bd4f-b10a6598a63c%40sessionmgr4009.
  • Kalisch BJ, Xie B. Errors of omission missed nursing care. West J Nurs Res. 2014;36(7):875-90. doi: 10.1177/0193945914531859.
  • Kalisch BJ, Lee KH. The impact of teamwork on missed nursing care. Nurs Outlook. 2010;58(5):233-41. doi:10.1016/j.outlook.2010.06.004.
  • Donabedian A. The quality of care: how can it be assessed? Jama. 1988;260(12): 1743-48.
  • Blackman I, Henderson J, Willis E, Hamilton P, Toffoli L, Verrall C, et al. Factors influencing why nursing care is missed. J Clin Nurs. 2015;24(1-2):47-56. doi: 10.1111/jocn.12688.
  • Henderson J, Willis E, Blackman I, Toffoli L, Verrall C. Causes of missed nursing care: qualitative responses to a survey of australian nurses. Labour & Industry: A Journal of the Social and Economic Relations of Work. 2016;26(4):281-97.
  • Jangland E, Teodorsson T, Molander K, Muntlin Athlin Å. Inadequate environment, resources and values lead to missed nursing care: A focused ethnographic study on the surgical ward using the fundamentals of care framework. J Clin Nurs. 2018;27(11-12):2311-21. doi: 10.1111/jocn.14095.
  • Kalisch BJ, Tschannen D, Lee KH. Missed nursing care, staffing, and patient falls. J Nurs Care Qual. 2012;27(1):6-12. doi: 10.1097/NCQ.0b013e318225aa23.
  • Kalisch BJ, Tschannen D, Lee KH. Do staffing levels predict missed nursing care? Int J Qual Health Care. 2011;23(3):302-8. doi: 10.1093/intqhc/mzr009.
  • Kalisch BJ, Landstrom G, Williams RA. Missed nursing care: Errors of omission. Nurs Outlook. 2009;57(1):3-9. doi:10.1016/j.outlook.2008.05.007.
  • Ausserhofer D, Zander B, Busse R, Schubert M, De Geest S, Rafferty AM, et al. Prevalence, patterns and predictors of nursing care left undone ın european hospitals: results from the multicountry cross-sectional rn4cast study. BMJ Quality & Safety. 2014;23(2):126-35. doi:10.1136/bmjqs-2013-002318.
  • Kalisch BJ, Williams RA. Development and psychometric testing of a tool to measure missed nursing care. J Nurs Adm. 2009;39(5):211-19. doi: 10.1097/NNA.0b013e3181a23cf5.
  • Palese A, Ambrosi E, Prosperi L, Guarnier A, Barelli P, Zambiasi P, et al. Missed nursing care and predicting factors in the Italian medical care setting. Intern Emerg Med. 2015;10(6):693-702. doi:10.1007/s11739-015-1232-6.
  • Tubbs-Cooley HL, Gurses AP. Missed nursing care: understanding and ımproving nursing care quality in pediatrics. Hosp Pediatr. 2017;7(7):424-26. doi:https://doi.org/10.1542/hpeds.2017-0083.
  • Ball JE, Murrells T, Rafferty AM, Morrow E, Griffiths P.Care left undone’during nursing shifts: associations with workload and perceived quality of care. BMJ Quality & Safety. 2014;23(2):116-25. doi:10.1136/bmjqs-2012-001767.
  • Spetz J, Harless DW, Herrera CN, Mark BA. Using minimum nurse staffing regulations to measure the relationship between nursing and hospital quality of care. Med Care Res Rev. 2013;70(4):380–99. doi: 10.1177/1077558713475715.
  • Frith KH, Anderson EF, Caspers B, Tseng F, Sanford K, Hoyt NG, Moore K. Effects of nurse staffing on hospital-acquired conditions and length of stay in community hospitals. Qual Manag Health Care. 2010;19(2):147–55. doi: 10.1097/QMH.0b013e3181dafe3f.
  • O’Brien-Pallas L, Li XM, Wang S, Meyer RM, Thomson D. Evaluation of a patient care delivery model: System outcomes in acute cardiac care. Can J Nurs Res 2010;42(4):98–120.
  • Weiss ME, Yakusheva O, Bobay KL. Quality and cost analysis of nurse staffing, discharge preparation and postdischarge utilization. Health Serv Res. 2011;46(5);1473–94. doi: 10.1111/j.1475-6773.2011.01267.x.
  • Lucero RJ, Lake ET, Aiken LH. Nursing care quality and adverse events in US hospitals. J Clin Nurs. 2010;19(15–16):2185–95. doi: 10.1111/j.1365-2702.2010.03250.x.
  • Schubert M, Clarke SP, Glass TR, Schaffert-Witvliet B, De Geest S. Identifying thresholds for relationships between impacts of rationing of nursing care and nurse- and patient-reported outcomes in Swiss hospitals: A correlational study. Int J Nurs Stud. 2009;46(7):884–93. doi:10.1016/j.ijnurstu.2008.10.008.
  • Stimpfel AW, Sloane DM, Aiken LH. The longer the shifts for hospital nurses, the higher the levels of burnout and patient dissatisfaction. Health Affairs. 2012;31(11):2501-9. doi: 10.1377/hlthaff.2011.1377.
  • Gutierrez KM. Critical care nurses' perceptions of and responses to moral distress. Dimens Crit Care Nurs. 2005;24(5):229-41.
  • Duffy JR, Culp S, Padrutt T. Description and factors associated with missed nursing care in an acute care community hospital. J Nurs Adm. 2018;48(7/8):361-67. doi: 10.1097/NNA.0000000000000630.
  • Kalisch B, Tschannen D, Lee H, Friese C. Hospital variation in missed nursing care. Am J Med Qual. 2011;26(4):291-99. doi: 10.1177/1062860610395929.
  • Sepulveda-Pacsi AL, Soderman M, Kertesz L. Nurses' perceptions of their knowledge and barriers to ambulating hospitalized patients in acute settings. Appl Nurs Res. 2016;32:117-121. http://dx.doi.org/10.1016/j.apnr.2016.06.001.
  • Doherty-King B, Bowers B. Attributing the responsibility for ambulating patients: A qualitative study. Int J Nurs Stud. 2013;50(9):1240–46.
  • Winters R, Neville S. Registered nurse perspectives on delayed or missed nursing cares in a New Zealand Hospital. Nurs Prax N Z. 2012;28(1):19-28.
  • Cho SH, Yun SC. Bed-to-nurse ratios, provision of basic nursing care, and in-hospital and 30-day mortality among acute stroke patients admitted to an intensive care unit: Cross-sectional analysis of survey and administrative data. Int J Nurs Stud. 2009;46(8):1092-101.
  • Castner J, Wu YWB, Dean-Baar S. Multi-level model of missed nursing care in the context of hospital merger. West J Nurs Res. 2015;37(4):441-61.
  • Griffiths P, Ball J, Drennan J, Dall’Ora C, Jones J, Maruotti A, et al. Nurse staffing and patient outcomes: Strengths and limitations of the evidence to inform policy and practice. A review and discussion paper based on evidence reviewed for the national ınstitute for health and care excellence safe staffing guideline development. Int J Nurs Stud. 2016;63:213-25.
  • Needleman J, Buerhaus P, Pankratz VS, Leibson CL, Stevens SR, Harris M. Nurse staffing and inpatient hospital mortality. New England Journal of Medicine. 2011;364(11):1037-45.
  • Needleman J, Buerhaus P, Mattke S, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care in hospitals. New England Journal of Medicine. 2002;346(22):1715-22.
There are 35 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research
Authors

Nagihan İlaslan 0000-0001-7895-040X

Nuriye Yıldırım Şişman 0000-0003-3745-3751

Publication Date December 29, 2019
Acceptance Date March 13, 2019
Published in Issue Year 2019 Volume: 44 Issue: 4

Cite

MLA İlaslan, Nagihan and Nuriye Yıldırım Şişman. “Bir üniversite Hastanesinde karşılanmayan hemşirelik bakım Gereksinimi Miktarı Ve Nedenleri”. Cukurova Medical Journal, vol. 44, no. 4, 2019, pp. 1226-3, doi:10.17826/cumj.509488.