| Objective:1.To introduce the concept and related theories and research of missed nursing care, and strengthen the awareness of nurses in China on the missed nursing care.2.To introduce the Missed Nursing Care Scale(MNCS)developed by Kalisch, translate it into Chinese and make a culture adaptation in a Chinese context and assess the reliability and validity,and explore the applicability of the Chinese version of the MNCS(nurse and patient edition)in China.3.To investigate and compare the perceptions of missed nursing care between nurses and patients in hospitals using the Chinese version of the MNCS,grasp the current situation and reasons and analyze the influencing factors of missed nursing care, take appropriate preventive measures in a targeted manner,and provide evidence for effectively reducing the occurrence of missed nursing care in the hospital.Methods:1.Literature search on CNKI,Wanfang Database and Pub Med with "missed nursing care" as the subject word to obtain the related data of missed nursing care.2.Get authorization to use MNCS from Kalisch and then to translate,back-translation,expert consultation,and pre-testing of the scale to form a Chinese version of the MNCS.3.595 nurses in clinical departments of two tertiary hospitals and 250 patients in a tertiary hospital were selected by stratified convenience sampling in Anhui Province was pre-investigated.Project analysis,exploratory factor analysis,internal consistency reliability and test-retest reliability were used to evaluate the reliability and validity of the Chinese version of the MNCS through to form a formal Chinese version of the MNCS(nurse and patient edition).4.616 clinical nurses in two third-level hospitals and two secondary hospitals using the Chinese nurse version of the MNCS and 250 patients in a tertiary hospital using the Chinese patient version of the MNCS in Anhui Province were investigated.Frequency descriptive analysis,t-test,analysis of variance,?2 test and stepwise multiple regression analysis were used to grasp the current status and influencing factors of missed nursing care in hospitals.Results:1.The reliability and validity evaluation results of the Chinese version of the MNCSThe Chinese nurse version of MNCS included 24 nursing activities in part A and 19 reasons of missed nursing care in part B,the average content validity index of the scale level(S-CVI/Ave)was 0.978 and 0.938 respectively,and the content validity index of the item level(I-CVI)was 0.833 ~ 1.000,the total Cronbach?s ?coefficient was 0.924 and 0.916 respectively,the total test-retest reliability was0.914 and 0.897 respectively,four factors(management,communication,labor resources and material resources)were extracted by explore factor analysis which could explain 64.308% of the total variance,the construct of the scale was more or less the same as that by Kalisch.The Chinese patient version of MNCS included 13 nursing activities items,S-CVI/Ave was 0.936,and I-CVI was 0.833~ 1.000,three factors(Communicative care,basic care and timely care)were extracted by explore factor analysis which could explain 65.044% of the total variance,the construct of the scale was the same as that by Kalisch,the total Cronbach?s ? coefficient is 0.888,the Cronbach?s ? coefficient of each dimension is 0.734~0.887,the total test-retest reliability is 0.843,and the test-retest reliability of each dimension is 0.769~0.821,.2.The results of the status and influencing factors of missed nursing careMissed nursing care in hospitals was widespread,with 97.5% of nurses reporting that they have at least lost one nursing activity,the 5 most frequently cited missed items of nursing activities were cleaning care,rehabilitation guidance,emotional support,changing sheets and health education.100% of the patients reported that the nurse had at least lost one nursing activity,and the patient considered that the most five missed nursing care were body cleansing,considering suggestions,assisting or urging to get out of bed,patiently listening and answering question,explain disease related knowledge.There are significant differences in the scores of different hospitals,departments,ages,length of service,highest academic qualifications,professional titles,shift schedules,and whether there are extra vacations on the missed nursing care.Missed nursing care were significantly negatively correlated with career satisfaction,job satisfaction,teamwork satisfaction.Nurses believed that the main reason for the missed nursing care is the lack of labor resources,followed by ineffective nursing management,lack of material resources and communication barriers.Teamwork satisfaction,highest education,professional title,labor resources,and nursing management are important factors influencing the missed nursing care.If the patients think that the nursing staff is not adequate,the patients think that the nursing staff had more missed nursing care,and the lower the patient's score on the hospital,the less likely it is to recommend the hospital to friends and family around.Conclusion:1.The MNCS was found to be a good reliable and valid instrument in Chinese version,and can be applied to the assessment for the missed nursing care of nurses and patients by hospital nursing organization in China.2.Missed nursing care in hospitals was widespread.Nursing managers should pay attention to the missed nursing care.According to the influencing factors and reasons of missed nursing care,nursing managers should take corresponding preventive measures,enhance the sense of team cooperation,increase the allocation of nursing staff,set up nursing positions reasonably,and improve the management effectiveness of nursing work,ensure the resources are in place,improve communication skills,effectively reduce the occurrence of missed nursing care,improve the quality of care,and improve the patient's bad experience. |
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