[MISSCARE Survey - Italian Version: findings from an Italian validation study]. / MISSCARE Survey - Versione Italiana: risultati dello studio di validazione di uno strumento per la rilevazione delle cure infermieristiche mancate.

BACKGROUND: The Missed Nursing Care (MNC) refers to nursing interventions that are not completed, partially completed, or postponed. Despite the relevance of MNC, no assessment tools are available in the Italian context, and no data regarding the occurrence of this phenomenon has been documented on a large scale to date. OBJECTIVES: The study aims were: (1) to validate the Italian version of the MISSCARE Survey tool; (2) to measure the prevalence of missed interventions and reasons for missed care as perceived by clinical nurses working in Italian health care settings. METHODS: After having conducted the forward and backward translation, pre-pilot and pilot phases were developed to ensure face and content validity as well as semantic and conceptual equivalence of the Italian version with the original version. The MISSCARE survey questionnaire was then distributed to 1,233 clinical nurses of whom 1,003 completed the questionnaire. Overall, 979 questionnaires were analysed. The questionnaires were completed from January to March 2012, by nurses working in medical and surgical hospital departments in the Emilia Romagna region of Italy. Construct validity and internal consistency of the instrument were assessed. RESULTS: The face and content validity were ascertained by a group of experts. The instrument acceptability was good given that 79.4% of respondents replied to all items. Construct validity was investigated by an Exploratory Factor Analysis. Four factors explaining 64.18% of variance emerged: communication, lack of facilities/supplies, lack of staff, and unexpected events. Internal consistency, evaluated with Cronbach a, was 0.94. The nursing interventions omitted with greater frequency were, in order: ambulation (74.8%), passive mobilization (69.6%) and oral care (51.3%). The three main reasons for missed interventions were: an unexpected increase in the number of patients (90.5%), increased instability of the clinical condition (86.1%) and insufficient human resources (85.5%). CONCLUSIONS: The Italian version of the MISSCARE Survey was shown to have good psychometric properties. Therefore, it can be used to evaluate the missed nursing care phenomenon in Italy and will allow for international comparisons.

Evaluation of the impact of support for nursing research on scientific productivity in seven Italian hospitals: A multiple interrupted time series study.

BACKGROUND: Nursing research is not well-developed in Italy, and knowledge of the methodologies for conducting research is lacking. In several hospitals, including those in which this study was conducted, a research center has been established to support and educate nurses on how to conduct clinical research. AIMS AND OBJECTIVES: In this observational study, we sought to assess whether establishing a support center for nursing research has resulted in an increase in scientific production in terms of the numbers of protocols approved (primary outcome), articles published and nurse authors involved in the publications (secondary outcomes). DESIGN: Multiple interrupted time series. METHODS: Data from 2002 to 2012 were collected in seven hospitals. Research centers have been established at various times in only four of these hospitals. RESULTS: A statistically significant increase in the primary outcome (the number of protocols approved by the Research Ethics Committee in which the principal investigator was a nurse) was observed in two hospitals approximately 2years after establishing a research center. The number of nursing research articles published in scientific journals with an impact factor increased but was not statistically significant. Finally, the number of nurse authors increased significantly in two hospitals with support units. Definitive conclusions could not be reached for the other two experimental hospitals because notably few post-intervention data were available. In the control hospitals, the scientific production outcomes did not change. CONCLUSIONS: This study shows that establishing a support center for nursing research inside hospitals can facilitate the production of research.

[The concept of missed care: a literature review]. / Il concetto di missed nursing care: una revisione narrativa della letteratura.

AIM: To describe the concept and consequences of missed nursing care. METHODS: A literature review was conducted searching on Medline, Trip Database, Cinahl, Cochrane, with the following key words: missed care, missed nursing care. RESULTS: Any needed nursing intervention omitted (totally or in part) or postponed is considered missed care. The causes of missed care are the scarcity of human resources, of equipment or communication, but also the criteria for setting priorities and the relationships with nurses aids may also have an impact. The missed care may be measured with the Misscare tool: those more frequently missed are deambulation, passive mobilization, hygiene and oral care. CONCLUSIONS. A description of the interventions omitted or only postponed at international level, a measurement of the variability of missed care according to the number of nurses, and their impact on patients'outcomed could improve a better understanding of this problem.