The Omission of Nursing Care in Emergency Departments: A Conceptual Analysis Using Walker & Avant's Methodology.
Josiane Provost, Émilie Gosselin, Christian M Rochefort
PMID 40312932WHAT IT FOUND
Essential emergency nursing tasks such as monitoring, pain reassessment and discharge instructions can be left undone when staffing, workload and equipment gaps combine.
No emergency-specific tool captures this well.
Key findings
01The analysis defines omission of nursing care in emergency departments as incomplete essential care, delayed or interrupted priority interventions, and care not given within the required timeframe.
02Understaffing and high patient volume are identified as key factors that increase the likelihood of missed nursing care in emergency departments.
03No existing instrument, including MISSCARE, has been specifically adapted for emergency department settings.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a concept analysis, not a patient study or intervention trial. The model cases come from the author's first-year nursing experiences, so they illustrate the concept but do not show how often it happens or what outcomes follow. The search was limited to accessible databases and to English and French articles. Included studies varied in definitions and measurements, and many relied on nurses' self-reports. The findings focus on emergency departments and may not apply to other settings. The recommendations for staffing, training, reporting and technology are proposed but not tested.
Declared interests
The authors declare no conflicts of interest. No funding source is stated in the supplied text.
The easy way to misread this
Do not read the staffing, training and reporting recommendations as proven ways to reduce missed care. This paper analyses the concept and does not test any intervention.