Association between Nursing Communication and Missed Nursing Care by Nurses at University Teaching and Referral Hospital in Rwanda

Abstract

Introduction: Omitting nursing care is a challenging concern in healthcare settings. This concept has not been addressed much, especially in the African context. This missing is related to any prescribed or administered activity by a nurse, omitted, delayed, or left undone. Focusing on identifying them and their associated factors will assist healthcare providers in improving the patient's outcomes. Objective: The aims of this study was to determine the levels, types and the communication factors that influence missed nursing Care activities by nurses at the University Teaching and Referral Hospital of Kigali in Rwanda.  Materials and Methods: This study was cross-sectional descriptive correlation design. The study used census method of sampling technique to obtain participants. The researcher used MISSCARE survey questionnaires for data collection. The data were analysed using SPSS version 26.0. Frequencies, percentages, chi-square and multinomial logistic regression were computed to find relationships between independent and dependent variables at 95% confidential interval and significance level of 5%. The results were presented using tables, figures. Results: Two hundred and one nurses took part in the study, 56.7% were female and 46.3% were male. The majority were aged 31-40 years, 54.2% had Diploma, 42.3% had bachelor while 3.5% had master’s degree, and 75.6% were married. The mean experience in nursing and in current unit were 13years and 7years respectively. The majority (46.73%) responded that missed nursing care was regarded as moderate while 29.65% perceived them as high across the assessed departments. The results also showed that replying to call alarms within 5 minutes (29.9%), joining interdisciplinary whenever held (25.4%), documentation of necessary information (24.9%), monitoring intake and output (21.9%) and patient health education (18.4%) were always being missed by nurses. Chi square test showed that all elements of communication were statistically significant factors associated with level of missed nursing care activities. Discussion: The finding revealed that the level of missed nursing care at the hospital as moderate and the level of missed nursing care was different across the hospital. The top five nursing activities that have always been missed were replying to call alarms within 5 minutes, joining interdisciplinary whenever held, documentation of necessary information, monitoring intake and output, and patient health education. The findings of the study showed that nursing communication was the main factor influencing missed nursing care. Conclusions: The study findings showed that level of missed nursing care was moderate and MNC were different across the hospital. It also indicated nursing communication factors were the most significant factors.  The study also highlighted the top five missed nursing care that are perceived to be always missed. Recommendation:  Ensure that efficient and effective communication among the nurses, medical staff and other stakeholders.