After hours nurse staffing, work intensity and quality of care - missed care study: New South Wales public and private sectors. Final report to the New South Wales Nurses and Midwives' Association

Abstract

The MISSCARE survey was developed by Beatrice Kalisch who defines missed care as “required patient care that is omitted (either in part or in whole) or delayed” and is a response, she claims, to “multiple demands and inadequate resources”. The MISSCARE survey has three components: demographic and workplace data; missed nursing care, which consists of a list of nursing tasks which had been identified; and reasons for missed care. Core nursing tasks routinely omitted in Kalisch’ studies are discharge planning and patient education, emotional support, hygiene and mouth care, documentation of fluid intake and output, ambulation, feeding and general nursing surveillance of the patient. Nurses and midwives consistently attributed instances of missed care to inadequate staffing levels, unexpected heavy workloads, too few resources, lack of supplies, shift rosters with an inappropriate mix of nursing skills, inadequate handovers, orientation to the ward and poor teamwork.