A comparison of patient care units with high versus low levels of missed nursing care.

BACKGROUND In a previous study, the nursing staff on 110 patient care units in 10 hospitals participated in a quantitative study of missed nursing care. PURPOSE The aim of this study was to gain an understanding of the differences in patient care units that had the most missed nursing care with those with the least missed nursing care. METHODOLOGY Focus groups were conducted with the registered nurse staff on the 5 units with the most missed nursing care and 5 units with the least missed care. FINDINGS Ten themes were identified: (a) staffing levels, (b) communication, (c) collective orientation, (d) backup, (e) monitoring, (f) leadership, (g) long tenure, (h) unit size, (i) trust, and (j) accountability. Taken together, the predominant difference found was that units with the least missed care had higher teamwork. PRACTICE IMPLICATIONS Strategies for developing interventions to decrease missed care and increase teamwork are presented.

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