Multi-Level Model of Missed Nursing Care in the Context of Hospital Merger

被引:37
作者
Castner, Jessica [1 ]
Wu, Yow-Wu B. [1 ]
Dean-Baar, Susan [2 ]
机构
[1] SUNY Buffalo, Buffalo, NY 14214 USA
[2] Univ Missouri St Louis, St Louis, MO USA
关键词
missed nursing care; medical errors; hospital merger; multi-level analysis; CONSOLIDATION; ACQUISITIONS; TEAMWORK; QUALITY; IMPACT; STAFF;
D O I
10.1177/0193945914535670
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
The aim of this study was to delineate the multi-level relationships of individual registered nurse (RN) and nursing unit factors on missed nursing care. This was a quantitative model-building study using a descriptive, cross-sectional design. Surveys (N = 553) and administrative unit records from nurses in one hospital system undergoing merger were included. The results showed that 36% of the variation in missed nursing care is due to the unit context, with a corresponding 64% due to individual nurse differences. At the unit level, workload, skill mix, and critical unit type affected the amount of missed nursing care. At the individual nurse level, more experience, supplies problems, communication problems, and involvement in errors of commission all increased the perception of the amount of missed nursing care. Education level was not related to the amount of missed nursing care. The findings highlight the importance of unit- and individual-level interventions to redesign hospital nursing care.
引用
收藏
页码:441 / 461
页数:21
相关论文
共 32 条
[1]   'Care left undone' during nursing shifts: associations with workload and perceived quality of care [J].
Ball, Jane E. ;
Murrells, Trevor ;
Rafferty, Anne Marie ;
Morrow, Elizabeth ;
Griffiths, Peter .
BMJ QUALITY & SAFETY, 2014, 23 (02) :116-125
[2]   Hospital reorganization and restructuring achieved through merger [J].
Bazzoli, GJ ;
LoSasso, A ;
Arnould, R ;
Shalowitz, M .
HEALTH CARE MANAGEMENT REVIEW, 2002, 27 (01) :7-20
[3]  
Benner P. E, 2009, NURSING PATHWAYS PAT
[4]   Critical Thinking, Delegation, and Missed Care in Nursing Practice [J].
Bittner, Nancy Phoenix ;
Gravlin, Gayle .
JOURNAL OF NURSING ADMINISTRATION, 2009, 39 (03) :142-146
[5]  
Brown Thomas C Jr, 2012, Healthc Financ Manage, V66, P114
[6]  
Castner J., J NURSING M IN PRESS
[7]  
Castner J., 2012, THESIS
[8]   EVALUATING QUALITY OF MEDICAL CARE [J].
DONABEDIAN, A .
MILBANK MEMORIAL FUND QUARTERLY-HEALTH AND SOCIETY, 1966, 44 (03) :166-206
[9]  
Donaldson M.S., 2000, To Err Is Human: Building a Safer Health System, V6
[10]   Fair and just culture, team behavior, and leadership engagement: The tools to achieve high reliability [J].
Frankel, Allan S. ;
Leonard, Michael W. ;
Denham, Charles R. .
HEALTH SERVICES RESEARCH, 2006, 41 (04) :1690-1709