The impact of "missed nursing care" or "care not done" on adults in health care: A rapid review for the Consensus Development Project.
Eileen Willis, Catherine Brady
PMID 34132481WHAT IT FOUND
Missed nursing care was linked to higher mortality and adverse events in some adult care studies but others found no link.
Most evidence came from nurses reporting omitted tasks, so it suggests association rather than proof of harm.
Key findings
01Three included studies reported a statistical link between missed nursing care and mortality, while two found no statistical link.
02Among 837 patients with non-ventilated hospital-acquired pneumonia, 50% did not have their bed elevated, one third were not assisted to walk daily, fewer than 16% had deep breathing exercises, fewer than 20% had incentive spirometry and less than 49.5% had mouth care.
03In nursing homes, failure to administer medications on time and to provide adequate surveillance had the strongest association with urinary tract infections.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
It is a rapid review, not a full systematic review, so it may have missed studies. The search excluded studies from South Africa, Central and South America, the Middle East and Eastern Mediterranean, and limited to English. Most included studies asked nurses to report missed care from memory, not direct observation or patient records. The evidence mostly shows correlation, not direct causation, and adjustments for patient, ward or hospital factors changed some mortality results. The review did not address patient satisfaction, and it focused on acute and aged care rather than community settings.
Declared interests
The work was funded by the University of Sheffield; the authors declared no competing interests.
The easy way to misread this
Do not conclude that missed nursing care caused deaths or complications. Most studies relied on nurses reporting missed tasks, and the review says direct causation is difficult to establish; some mortality links disappeared after adjustment for patient, ward or hospital factors.