Missed Care

Considerable evidence exists associating nursing staffing with patient outcomes, but less attention has been focused on the mechanisms of this association. A group of British researchers recently examined the concept of "missed care". This refers to the care tasks that nurses should have performed during their shift, but did not due to lack of time. Nurses were surveyed on 13 nursing activities that were felt to be necessary and how often they were not performed due to inadequate time. Staffing ratios were also assessed on these 401 general wards; ICUs were excluded. Care frequently left undone included adequate patient surveillance and patient education; least likely to be left undone was pain management and procedures. Nurses were more likely to report missed care on wards with high nurse to patient ratios and lower on wards with better practice environments.  The authors conclude that measuring "missed care" may be a good indicator of nursing care quality.