Factors Associated with Missed Nursing Care at a Tertiary Level Public Sector Hospital (Nurses’ Perspective)

Abstract

Background: Missed nursing care is the least researched aspect in nursing practice & research. There is a long list of determinants of this phenomenon; the current study is an effort to highlight various factors playing a pivotal role in missed nursing care. The research is carried out to evaluate missed nursing care and related socio-demographic determinants at a tertiary care hospital. Study Setting & Study Design: Descriptive cross-sectional study at Dr. Ruth K.M Pfau Civil Hospital Karachi. Study Population, Sample Size & Sampling Technique: Total 163 nurses were selected through convenient non-probability sampling. Data Collection & Analysis: A three-section questionnaire containing socio-demographic determinants, work related factors and elements of care were used to collect data.  Frequencies & percentages were computed for socio-demographic variables and their associations with missed nursing care were sought by applying Chi-square test. Results:  Mean age of the respondents were 38 ± 8.54 years.  The male: female ratio of respondents was 1:2.26; sixteen percent of the respondents reported frequently missed nursing care activity while doing assessment of patients. The assessments of the patients’ hygiene status were missed frequently by 21.5% of subjects. There was statistically significant association between age of the respondents & missed nursing care (p=0.04). The shortage of staff nurses was most frequently reported factor for missed nursing care (61.3%). Conclusions: The study reveals hygiene care of the patients as the most neglected element of nursing care. The 10% of participants significantly missed to fulfill the basic medical needs of patients. The 61.3% nurses reported shortage of nurses in a hospital as the determinant of missed nursing care.  Imparting necessary health education to patients was statistically significantly associated to professional educational level of the nurses (p=0.04). Recommendation: The study gives a guideline for hospital administrators regarding carrying out improvement in provision of optimal nursing care in relation to improved patient safety.