WHAT IS KNOWN ON THE SUBJECT: Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care. This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE: The findings of this review contribute valuable information to inform evidence-based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings. In addition, the review illuminates the far-reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. WHAT ARE THE IMPLICATIONS FOR PRACTICE: Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them. In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery. Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity-focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. ABSTRACT: INTRODUCTION: Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting. AIM: To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings. METHODS: The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta-analyses. RESULTS: This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient. DISCUSSION: The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings. IMPLICATION FOR PRACTICE: Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting.
Nežiaduce udalosti predstavujú globálny problém s negatívnym dopadom na bezpečnosť pacientov. Jedným z kľúčových nástrojov na zvýšenie kvality starostlivosti a bezpečnosti pacientov je hlásenie týchto udalostí. Cieľom štúdie bolo zistiť, aká je frekvencia hlásenia nežiaducich udalostí, aké faktory ovplyvňujú frekvenciu hlásenia, a aké bariéry hlásenia nežiaducich udalostí vnímajú sestry pracujúce na jednotkách intenzívnej starostlivosti (JIS) vo vybraných nemocniciach Slovenskej republiky. Zber údajov prebiehal od júla do októbra 2023 prostredníctvom dotazníka pozostávajúceho z troch častí: frekvencia hlásenia, bariéry a demografické údaje. Výskumný súbor zahŕňal 153 sestier zo štyroch slovenských nemocníc. Údaje boli spracované pomocou deskriptívnej a inferenčnej štatistiky. Frekvencia hlásenia dosiahla skóre 3,39 (SD = 1,33), čo naznačuje priemerné hlásenie nežiaducich udalostí. Faktory ako spokojnosť na pracovisku, materiálne vybavenie, vnímaná bezpečnosť pacientov a vzdelanie sestier významne ovplyvňovali hlásenie. Medzi najvýznamnejšie bariéry patrili nedostatočné vedomosti o tom, ktoré udalosti hlásiť, slabé povedomie o vzniku udalostí a nejasnosti v procese hlásenia. Napriek relatívne vysokej frekvencii hlásenia nežiaducich udalostí na JIS pretrvávajú bariéry, ktoré obmedzujú jeho efektivitu. Kľúčovými výzvami je nedostatok vedomostí a jasných inštrukcií, ktoré je potrebné riešiť prostredníctvom vzdelávania a organizačných opatrení. Podpora faktorov ako spokojnosť na pracovisku a dostupnosť zdrojov môže prispieť k zvýšeniu bezpečnosti pacientov a kvality starostlivosti.
Adverse events represent a global issue with a significant negative impact on patient safety. Reporting these events is one of the key tools for improving the quality of care and patient safety. The aim of this study was to determine the frequency of adverse event reporting, identify factors influencing reporting frequency, and explore barriers to adverse event reporting as perceived by nurses working in intensive care units (ICUs) in selected hospitals in Slovakia. Data collection took place from July to October 2023 through a questionnaire consisting of three sections: reporting frequency, barriers, and demographic information. The sample included 153 nurses from four Slovak hospitals. Data were analyzed using descriptive and inferential statistics. The reporting frequency score was 3.39 (SD = 1.33), indicating relatively average reporting of adverse events. Factors such as workplace satisfaction, material resources, perceived patient safety, and nurse education significantly influenced reporting. The most critical barriers identified were insufficient knowledge about which events to report, limited awareness of adverse event occurrence, and unclear reporting processes. Despite the relatively high frequency of adverse event reporting in ICUs, barriers limiting its effectiveness persist. Key challenges include a lack of knowledge and clear guidelines, which should be addressed through education and organizational measures. Supporting factors such as workplace satisfaction and resource availability could further enhance patient safety and care quality
AIMS: Missed nursing care (MNC) significantly affects patient safety and quality of care. It is a widely used concept that has been studied in different settings, but research in paediatric care is quite limited. Therefore, this descriptive cross-sectional study aimed to report the prevalence, patterns, correlates, factors and predictors of MNC in paediatric care units in two central European countries. DESIGN: A cross-sectional comparative study. METHODS: Data collection was carried out between June and November 2021 using the MISSCARE Survey-Pediatric. The study included 441 registered nurses working in paediatric care units in the Czech Republic and Slovakia. Data were analysed using descriptive and inferential statistics in the SPSS 25.0 statistical program. RESULTS: Almost all nurses, 92.7% of nurses missed at least one nursing activity during the last shift. The most missed care activity in both countries was the promotion of neuroevolutionary development, and the most prominent reasons were labour resources. MNC was weakly but significantly correlated with nurse experience in the current position and was predicted by the country, nurse education and overtime hours (p ≤ .05). Differences in prevalence of MNC and reasons for MNC were identified based on several variables (p ≤ .05). CONCLUSION: The assessment of MNC in paediatric settings is often a neglected area, although the prevalence in this study was moderate. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurse staff shortages, as a global problem, have many impacts on patient outcomes in the delivery of nursing care. However, there are also many factors that can reduce the prevalence of MNC. More research should focus on a closer examination of these factors that involve hospital and nurse variables. REPORTING METHOD: The study was carried out according to the STROBE checklist and the RANCARE guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
- MeSH
- dětské sestry * MeSH
- dítě MeSH
- lidé MeSH
- nemocnice MeSH
- ošetřovatelská péče * MeSH
- personál sesterský nemocniční * MeSH
- průřezové studie MeSH
- průzkumy a dotazníky MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Background and Purpose: Nursing students have an essential role in patient safety. The purpose of this study was to evaluate the face validity, content validity, and psychometric properties of the Hospital Survey on Patient Safety Culture for Nursing Students (HSOPS-NS). Methods: The cross-sectional study was carried out between January and October 2021. The participants were undergraduate nursing students (N = 482) from 16 Czech nursing faculties. Results: Exploratory factor analysis revealed an 8-factor structure, which was verified by confirmatory factor analysis using the optimization process that results in adequate goodness-of-fit indices (root mean squared error approximation = .037; standardized root mean squared residuals = .056; comparative fit index = .935; Tucker-Lewis index = .926; incremental fit index = .936). The internal consistency of a new model was excellent (α = .914). Conclusion: The results indicate that the HSOPS-NS shows evidence of reliability and validity and is a valuable measure of safety culture as perceived by nursing students.
- MeSH
- bezpečnost pacientů * normy statistika a číselné údaje MeSH
- dospělí MeSH
- faktorová analýza statistická MeSH
- lidé MeSH
- mladý dospělý MeSH
- organizační kultura MeSH
- průřezové studie MeSH
- průzkumy a dotazníky normy MeSH
- psychometrie * normy MeSH
- reprodukovatelnost výsledků MeSH
- řízení bezpečnosti normy MeSH
- studenti ošetřovatelství * statistika a číselné údaje psychologie MeSH
- studium ošetřovatelství bakalářské * normy statistika a číselné údaje MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- validační studie MeSH
Nedokončená ošetrovateľská starostlivosť predstavuje bežný fenomén v zdravotníckych zariadeniach, a to najmä v dôsledku pôsobenia systémových faktorov, ako sú nedostatok personálu, či materiálu. Študenti ošetrovateľstva sú neoddeliteľnou súčasťou ošetrovateľských tímov a vnímajú tento fenomén, ako aj jeho príčiny počas svojej klinickej praxe. Cieľom našej štúdie bolo zistiť, aké sú názory študentov ošetrovateľstva bakalárskeho študijného programu na výskyt nedokončenej ošetrovateľskej starostlivosti počas ich poslednej klinickej praxe. Výskumný súbor tvorilo 49 študentov, ktorí odpovedali na otvorenú otázku v nástroji Unfinished Nursing Care Scale for Nursing Students. Zber údajov prebiehal medzi septembrom a decembrom 2023. Získané údaje boli analyzované pomocou sumatívnej obsahovej analýzy. Na jej základe sme identifikovali štyri nosné kategórie, ktoré reprezentovali príčiny výskytu nedokončenej starostlivosti z perspektívy študentov ošetrovateľstva, a to: Prístup sestier; Prístup lekárov; Manažment a kontrola; Nedostatok personálu. Z výsledkov je zrejmé, že študenti dokážu rozpoznať fenomén nedokončenej ošetrovateľskej starostlivosti, ako aj príčiny, ktoré k nemu vedú. Výsledky, ktoré sme získali, sa vzťahujú najmä k manažmentu zdravotníckych zariadení, v ktorých študenti realizujú klinickú prax. Manažment týchto zariadení by mal prijať potrebné opatrenia s cieľom eliminácie nedokončenej ošetrovateľskej starostlivosti z prostredia klinickej praxe. Ďalšie výskumy by sa mali zameriavať na detailnejšiu analýzu príčin nedokončenej ošetrovateľskej starostlivosti z perspektívy študentov ošetrovateľstva.
Unfinished nursing care represents a common phenomenon in healthcare facilities, primarily due to the influence of systemic factors such as understaffing and material shortages. Nursing students are integral members of nursing teams and perceive this phenomenon, along with its causes, during their clinical practice. Our study aimed to explore the perspectives of bachelor’s degree nursing students on the occurrence of unfinished nursing care during their latest clinical placement. The sample comprised 49 students who responded to an open-ended question in the Unfinished Nursing Care Scale for Nursing Students tool. Data collection took place between September and December 2023. The collected data were analyzed using summative content analysis. Based on this analysis, we identified four main categories representing the causes of unfinished care from the perspective of nursing students: Nurse attitude; Physician attitude; Management and control; Staff shortage. The results indicate that students can recognize the phenomenon of unfinished nursing care and its contributing factors. Our findings primarily relate to the management of healthcare facilities where students undertake clinical placement. Management of these facilities should take necessary measures to eliminate unfinished nursing care from the clinical practice environment. Further research should focus on a more detailed analysis of the causes of unfinished nursing care from the perspective of nursing students.
- Klíčová slova
- nedokončená ošetřovatelská péče,
- MeSH
- chybná zdravotní péče prevence a kontrola MeSH
- hodnocení rizik MeSH
- ochrana zájmů pacientů MeSH
- ošetřovatelská péče normy organizace a řízení MeSH
- průzkumy a dotazníky MeSH
- řízení kvality MeSH
- studenti ošetřovatelství MeSH
- studium ošetřovatelství bakalářské MeSH
OBJECTIVE: To examine nurse managers' perspectives on missed nursing care (MNC) on surgical units. BACKGROUND: The phenomenon of MNC is an important concern for nurse researchers. However, the reality of how it is experienced by clinical nurse managers is largely unexplored. Understanding nurse managers' experiences with MNC could help develop useful approaches to reducing levels of MNC. METHODS: A descriptive qualitative study was conducted between December and June 2020, using face-to-face semistructured interviews with 10 nurse managers. RESULTS: Five themes were identified: 1) awareness of MNC; 2) rationale for MNC; 3) consequences of MNC; 4) questions of reporting; and 5) management of MNC. CONCLUSIONS: Nurse managers must use their positions and leadership skills to expect appropriate staffing approaches and material resources for surgical units, effective process for newly hired nurses, and the establishment of a reporting system for MNC to reduce the phenomenon in practice.
- MeSH
- kvalitativní výzkum MeSH
- lidé MeSH
- ošetřovatelská péče * MeSH
- vůdcovství MeSH
- zdravotní sestry v řízení a kontrole * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Sestry predstavujú najväčšiu skupinu zdravotníckych pracovníkov a sú zodpovedné za zvyšovanie bezpečnosti pacientov vrátane hlásenia nežiaducich udalostí. Nežiaduce udalosti sú podceňované kvôli množstvu bariér, ktoré ohrozujú bezpečnosť pacienta v nemocničnom prostredí. Cieľom deskriptívnej kvalitatívnej štúdie bolo zistiť, aké bariéry vnímajú sestry v kontexte hlásenia nežiaducich udalostí. Výskumný súbor zahŕňal desať sestier s pokročilou praxou z jednotiek intenzívnej starostlivosti, ktoré pracovali vo vybranej univerzitnej nemocnici v Slovenskej republike. Zber údajov prebiehal v období od septembra 2022 do februára 2023 pomocou pološtruktúrovaných rozhovorov. Údaje boli nahrávané na audiozáznamník, následne doslovne prepísané a analyzované tematickou analýzou. Na základe tematickej analýzy sme identifikovali štyri hlavné bariéry hlásenia nežiaducich udalostí: Negatívny postoj k hláseniu nežiaducich udalostí; Nedostatok vedomostí a skúseností s hlásením nežiaducich udalostí; Dokumentovanie nežiaducich udalostí; Strach. Z výsledkov štúdie je zrejmé, že len účinné a pravidelné hlásenie nežiaducich udalostí vedie k minimalizácii výskytu nežiaducich udalostí. Na zlepšenie bezpečnosti pacientov v nemocniciach je potrebné zaviesť vzdelávacie a riadiace postupy na prekonanie bariér pri hlásení nežiaducich udalosti. Najvýznamnejším prístupom k prekonaniu bariér hlásenia nežiaducich udalostí je vytvorenie takého prostredia, ktoré je založené na úprimnosti, a v ktorom sestry nemajú strach hlásiť nežiaduce udalosti.
Nurses represent the largest group of healthcare professionals and are responsible for improving patient safety, including adverse event reporting. However, adverse events are underreported due to the many barriers that compromise patient safety in the hospital setting. The descriptive qualitative study aimed to investigate the barriers perceived by nurses of adverse event reporting. A research sample included ten advanced practice nurses from intensive care units working in a selected university hospital in the Slovak Republic. Data were collected between September 2022 and February 2023 using semi-structured interviews. Data were audio-recorded, then transcribed verbatim and analysed by thematic analysis. Based on the thematic analysis, we identified four meaningful barriers to reporting adverse events: Negative attitude towards reporting; Lack of information about reporting; Fear of reporting; Lack of knowledge and experience of adverse event reporting. Based on the study results, it is evident that only effective and regular reporting of adverse events leads to minimization of adverse events. To improve patient safety in hospitals, educational and management practices need to be put in place to overcome barriers to adverse event reporting. The most important approach to overcoming barriers to adverse event reporting is to create an environment that is based on honesty and in which nurses are not afraid to report adverse events
Profesionálna identita je považovaná za centrálny fenomén profesijného vývoja jednotlivca, ktorý integruje postoje a správanie vzťahujúce sa k profesii. Vytvára a formuje sa v procese socializácie. Pod socializáciou môžeme rozumieť postupné začleňovanie sa jednotlivca do spoločnosti prostredníctvom napodobňovania a identifikácie, najprv v základnej (nukleárnej) rodine, ďalej v malých spoločenských skupinách, až po zapojenie sa do najširších, celospoločenských vzťahov. Je to proces sociálneho učenia, v ktorom si jednotlivec osvojuje kultúru vlastnej spoločnosti a formuje sa ako sociálna i ako individuálna osobnosť. Socializácia tak predstavuje celoživotný proces. Pokiaľ hovoríme o profesionálnej socializácii, tak ide o periodický proces socializácie, ktorý pokračuje počas života jednotlivca. Socializácia v profesii je kľúčovou súčasťou sekundárnej socializácie. Profesionálna socializácia študentov ošetrovateľstva začína vstupom do študijného programu a pokračuje vstupom do pracovného procesu. Profesionálna socializácia je kritickým aspektom rozvoja študentov ošetrovateľstva. Je zamýšľaným ale aj nezamýšľaným dôsledkom vzdelávacieho procesu a získavania pracovných skúseností.
Professional identity is considered a central phenomenon of an individual’s professional development, integrating attitudes and behaviors related to the profession. It is developed and shaped in the process of socialization. By socialization, we understand the gradual integration of an individual into society through imitation and identification, first in the essential (nuclear) family, then in small social groups, up to participation in the broadest, society- wide relationships. It is a process of social learning in which individuals learn their own society’s culture and are formed as a social and individual personality. Socialization represents a lifelong process. If we talk about professional socialization, then it is a systematic socialization process that continues throughout an individual’s life. Socialization in the profession is a key part of secondary socialization. The professional socialization of nursing students begins with the entry into the study program and continues with the entry into the work process. Professional socialization is a critical aspect of the development of nursing students. It is an intended but also an unintended consequence of the educational process and the acquisition of work experience.
- Klíčová slova
- profesní identita, profesní socializace,
- MeSH
- klinické praxe MeSH
- socializace MeSH
- studenti ošetřovatelství MeSH
S formovaním profesijnej identity sestier súvisí aj nosenie uniformy. Uniformovaný vzhľad sestier zostáva vplyvným symbolom profesionality a podieľa sa na vytváraní profesionálneho imidžu profesie, teda ovplyvňuje vnímanie, dojmy, presvedčenia a predstavy, ktoré majú ľudia o sestrách a ošetrovateľstve. Symbolizuje odbornosť a od sestier sa očakáva, že majú zručnosti potrebné na výkon svojej práce, a že sú viazané určitými normami a etickými zásadami. Nosenie uniformy podporuje aj u študentov ošetrovateľstva vytváranie sebaobrazu a profesionálnej identity, čo môže viesť k lepšiemu pocitu sebadôvery a v konečnom dôsledku k lepšiemu výkonu v ošetrovateľskej praxi. Stále platí, že ošetrovateľské uniformy sú symbolom odhodlania a disciplíny vznešeného povolania.
The formation of the nurses' professional identity is closely related to wearing a uniform. The uniform appearance of nurses remains an influential characteristic of professionalism and contributes to the professional image of the profession, thus influencing the perception, impressions, beliefs, and ideas that people have about nurses and nursing. It symbolizes expertise, and nurses are expected to have the skills necessary to perform their work and to be bound by certain standards and ethical principles. Wearing a uniform also supports the creation of self-image and professional identity in nursing students, which can lead to a better feeling of self-confidence and, ultimately, to better performance in nursing practice. It is still true that nursing uniforms are a symbol of the determination and discipline of a noble profession.
- Klíčová slova
- uniforma, profesní identita, symbol odbornosti,
- MeSH
- odívání MeSH
- osobnost MeSH
- zdravotní sestry MeSH
Vysoký výskyt incidentov násilia pri výkone povolania je problémom sestier na medzinárodnej úrovni – sestry sú častejšie objektom násilia v porovnaní s inými zdravotníckymi profesionálmi. Cieľom našej štúdie bolo zistiť, aký je výskyt agresie pacientov voči sestrám a aké faktory ovplyvňujú jej výskyt z perspektívy sestier v Slovenskej republike. Zber údajov prebiehal medzi júnom a augustom 2022. Sestry boli oslovené pomocou portálu Slovenskej komory sestier a pôrodných asistentiek. Pre zber údajov boli použité dva nástroje a to Výskyt agresie pacientov voči sestrám (VAPS) a Faktory agresie pacientov voči sestrám (FAPAS). Údaje boli analyzované prostredníctvom deskriptívnej štatistiky. V našej štúdii bolo 100 % sestier konfrontovaných s agresiou pacientov v období posledného roku výkonu ich praxe, pričom najčastejšou formou agresie pacientov bol verbálny útok – urážky, nadávky. Ako najpodstatnejšie faktory ovplyvňujúce výskyt agresie pacientov voči sestrám boli v našom výskume identifikované tie, ktoré sa vzťahovali k charakteristikám pacientov. Výskum v oblasti agresie pacientov voči sestrám je v podmienkach Slovenskej republiky stále aktuálny vzhľadom na jej vysoký výskyt v klinickej praxi.
The high prevalence of incidents of occupational violence is a problem of nurses internationally – nurses are more often the object of violence compared to other health care professionals. Our study aimed to find out the incidence of patient aggression toward nurses and the factors affecting its incidence from the perspective of nurses in the Slovak Republic. Data were collected between June and August 2022. The nurses were recruited using the portal of the Slovak Chamber of Nurses and Midwives. Two instruments were used for data collection, namely Violence and Aggression of Patients Scale (the VAPS) and Factors Affecting Patient Aggression Scale (the FAPAS). Data were analyzed using descriptive statistics. In our study, 100% of nurses were confronted with patient aggression during the last year of their practice, while the most frequent form of patient aggression was verbal attack, insults, scolds. The most significant factors affecting the incidence of patient aggression towards nurses were those related to patient characteristics. Research in the field of patient aggression towards nurses is still relevant in the conditions of the Slovak Republic due to its high incidence in clinical practice.
