Wednesday, 28 March 2018

What leads to missed care?

Roger Watson, Editor-in-Chief

The concept of 'missed care' has been very prominent in nursing in recent years and has been extensively reported over the years in JAN. A recent UK study titled: 'The association between nurse staffing and omissions in nursing care: a systematic review' and published in JAN presents some interesting findings.

The study is by Griffiths et al. (2018) on behalf of the Missed Care Study Group and aimed to: 'identify nursing care most frequently missed in acute adult inpatient wards and to determine evidence for the association of missed care with nurse staffing.' Eighteen studies reporting missed care and meeting the criteria for the review were identified. 

The results are presented in detail in the article but, to summarise: 'Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy.'

The authors conclude: 'While reported missed care is associated with nurse staffing levels and such reports may indeed be indicators of inadequate nurse staffing, there is no research demonstrating associations with objective measures of care. The extent to which the relationships observed in these studies represent actual omissions of care and the consequences of such failures, remains largely uninvestigated. Future research should focus on objective measures of missed care to investigate the impact of missed care on patient outcomes.'

You can listen to this as a podcast.


Griffiths, P. , Recio‐Saucedo, A. , Dall'Ora, C. , Briggs, J. , Maruotti, A. , Meredith, P. , Smith, G. B., Ball, J. On behalf of the Missed Care Study Group (2018), The association between nurse staffing and omissions in nursing care: a systematic review. J Adv Nurs. doi:10.1111/jan.13564

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