Branching Paths: Unsafe Nurse Staffing and Patient Missed Care

The article investigates some of the possible causes for the rate of preventable medical error-related deaths, which is presently estimated to be the third leading cause of deaths globally. According to Hessels et al. (2018), one of the principles causes of medical error-related deaths is missed nursing care. Missed nursing care leads to adverse patient incidences such as increased discomfort and pain, delayed discharge, variation in medication, and the occurrence of falls and new infections. Some of the critical nursing care processes often neglected are planning (71%), primary care and interventions (73%), and assessment (44%) (Hessels et al., 2018). In a bid to address the adverse impacts of missed nursing care, the author proposes the adoption of voluntary adverse event reporting systems and the placing of higher demand for transparency. He also supports the introduction of a patient safety culture (PSC) that encourages the voluntary reporting of errors and misses while maintaining a nonpunitive environment. 

The research was the first-ever publication to explore the relationship between PSC and missed nursing care. It was prompted by the following three objectives: 1) determination of the characteristics of PSC that predict missed nursing care, 2) the features of nursing care that predict adverse patient safety incidences, and 3) the link between PSC and adverse patient safety events and influence on missed nursing care and other healthcare characteristics. The sample population comprised of over 500 registered nurses working in about 38 inpatient facilities and healthcare facilities that implement the adverse event reporting system referred to as CareLink (Hessels et al., 2018). From the research, most nurses admitted to missing certain aspects of nursing care. There was also a high prevalence of missed nursing among specialty certified nurses than among the noncertified nurses. PSC proved to be an accurate predictor of the frequency of missed nursing care. Lastly, a strong link was established between missed nursing care and incidences of patient falls. Therefore, it is without a doubt that PSC dimensions are an accurate predictor of nurse-related adverse events. 

Reference

Hessels, A. J., Paliwal, M., Weaver, S. H., Siddiqui, D., & Wurmser, T. A. (2018). Impact of Patient Safety Culture on Missed Nursing Care and Adverse Patient Events. J Nurs Care Qual, 34 , 287–294.