Exploration of the concept of missed nursing care was pioneered by Dr. Bea Kalisch, RN, of the University of Michigan. Her 2006 paper in the Journal of Nursing Care Quality, Missed nursing care: a qualitative study is a classic in the field.
She identified nine elements of regularly missed nursing care:
- delayed or missed feedings
- patient teaching
- discharge planning
- emotional support
- intake and output documentation
She also identified seven reasons for missing this care that were reported by nursing staff:
- too few staff
- poor use of existing staff resources
- time required for the nursing intervention
- poor teamwork
- ineffective delegation
In another paper (Missed nursing care: a concept analysis) she wrote:
The consequences of missed care are far-reaching in terms of patient outcomes. If the missed care, for example, is ambulation, a patient may be discharged from the hospital in a debilitated condition and may be required to have weeks of physical therapy. Not turning a patient may result in skin breakdown and pressure ulcer formation. The absence of patient teaching may lead to complications and readmission. Mouth care missed with ventilated patients may lead to ventilator-associated pneumonia. Not bathing a patient could lead to not detecting a skin breakdown at an early stage.
The work of Dr. Kalisch is directly relevant to the aims of NurseMind. Good checklists can go a long way toward remedying these nursing care omissions.