Missed nursing care in the critical care unit, before and during the COVID-19 pandemic: A comparative cross-sectional study.

OBJECTIVES: Todescribe and evaluate reported missed nursing care in the critical care context during different phases of the COVID-19 pandemic in Sweden. RESEARCH METHODOLOGY: A comparative cross-sectional design was used, comparing missed nursing care in three samples: before the COVID-19 pandemic in 2019, during the second wave of the pandemic in spring 2020, and during the third wave of the pandemic in fall 2021. SETTING: The study was conducted at critical care units at a university hospital, Sweden. MAIN OUTCOME MEASURES: The MISSCARE Survey-Swedish version was used to collect data along with two study-specific questions concerning perception of patient safety and quality of care. RESULTS: Significantly more overtime hours and number of days absent due to illness were reported during the pandemic. The nurse/patient ratio was above the recommended level at all data collection time points. Most missed nursing care was reported in items concerning basic care. The most reported reasons for missed nursing care in all samples concerned inadequate staffing, urgent situations, and a rise in patient volume. Most nurses in all samples perceived the level of patient safety and quality of care as good, and the majority had no intention to leave their current position. CONCLUSION: The pandemic had a great impact on the critical care workforce but few elements of missed nursing care were affected. To measure and use missed nursing care as a quality indicator could be valuable for nursing managers, to inform them and improve their ability to meet changes in patient needs with different workforce approaches in critical care settings.

Patient safety, quality of care and missed nursing care at a cardiology department during the COVID-19 outbreak.

AIM: To evaluate missed nursing care and patient safety during the first wave of the COVID-19 pandemic at in-patient cardiology wards. DESIGN: A cross-sectional design with a comparative approach. METHOD: Registered nurses and nurse assistants at a cardiology department were invited to answer the MISSCARE Survey-Swedish version, and questions on patient safety and quality of care during the COVID-19 pandemic. The data were compared with a reference sample. RESULTS: A total of 43 registered nurses and nurse assistants in the COVID-19 sample and 59 in the reference sample participated. The COVID-19 sample reported significantly more overtime hours and more absence from work due to illness in comparison with the reference sample. The patient safety and quality of care were perceived significantly worse, 76.7% (N = 33) versus 94.7% (N = 54), and 85.7% (N = 36) versus 98.3% (N = 58, respectively. The COVID-19 sample reported more missed nursing care in wound care and in basic nursing.

Missed nursing care during the COVID-19 pandemic: A comparative observational study.

AIM: To evaluate frequencies, types of and reasons for missed nursing care during the COVID-19 pandemic at inpatient wards in a highly specialized university hospital. BACKGROUND: Registered nurse/patient ratio and nursing competence are known to affect patient outcomes. The first wave of the COVID-19 pandemic entailed novel ways for staffing to meet the expected increased acute care demand, which potentially could impact on quality of care. METHODS: A comparative cross-sectional study was conducted, using the MISSCARE Survey. A sample of nursing staff during the first wave of the COVID-19 pandemic (n = 130) was compared with a reference sample (n = 157). RESULTS: Few differences between samples concerning elements of missed care and no significant differences concerning reasons for missed care were found. Most participants perceived the quality of care and the patient safety to be good. CONCLUSION: The results may be explained by three factors: maintained registered nurse/patient ratio, patients' dependency levels and that nursing managers could maintain the staffing needs with a sufficient skill mix. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers impact on the occurrence of MNC; to provide a sufficient registered nurse/patient ratio and skill mix when staffing. They play an important role in anticipatory planning and during infectious disease outbreaks.