Table 2.
Reasons for Missed Nursing Care across 10 Hospitals
| H1 (n=168) | H2 (n=46) | H3 (n=726) | H4 (n=469) | H5 (n=212) | H6 (n=198) | H7 (n=893) | H8 (n=198) | H9 (n=422) | H10 (n=754) | Total (n=4086) | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| |
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| Bed size | 347 | 60 | 760 | 317 | 304 | 411 | 880 | 433 | 479 | 913 | |
| |
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| Participating unit # |
5 | 2 | 15 | 11 | 6 | 8 | 22 | 9 | 14 | 18 | |
| Item | |||||||||||
| | |||||||||||
| Labor Resources - Overall | 92.4% | 95.6% | 87.0% | 92.4% | 91.7% | 93.7% | 95.8% | 93.6% | 96.3% | 94.2% | 93.1% |
| | |||||||||||
| 1. Inadequate number of staff | 94.6% | 95.6% | 84.3% | 88.2% | 93.6% | 90.8% | 93.2% | 92.8% | 95.1% | 92.6% | 91.1% |
| | |||||||||||
| 2. Urgent patient situations (e.g. a patient's condition worsening) | 92.1% | 95.6% | 87.5% | 92.1% | 90.6% | 91.3% | 95.5% | 93.3% | 94.4% | 92.8% | 92.4% |
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| 3. Unexpected rise in patient volume and/or acuity on the unit | 92.7% | 97.7% | 87.4% | 95.2% | 96.0% | 97.4% | 97.6% | 95.2% | 98.3% | 96.1% | 94.9% |
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| 4. Inadequate number of assistive personnel (e.g. nursing assistants, techs, unit secretaries etc.) | 96.4% | 93.3% | 87.2% | 93.4% | 89.6% | 92.8% | 96.8% | 95.3% | 97.4% | 96.2% | 94.0% |
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| 17. Heavy admission and discharge activity | 86.1% | 95.6% | 88.5% | 93.0% | 88.8% | 96.2% | 96.1% | 91.2% | 96.4% | 93.1% | 92.9% |
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| Material Resources - Overall | 83.9% | 91.0% | 88.1% | 86.3% | 87.9% | 90.0% | 91.4% | 93.7% | 93.4% | 89.1% | 89.6% |
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| 6. Medications were not available when needed | 88.6% | 95.2% | 93.2% | 95.4% | 89.8% | 96.4% | 95.6% | 95.2% | 97.8% | 94.2% | 94.6% |
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| 9. Supplies/equipment not available when needed | 85.2% | 91.1% | 87.6% | 86.2% | 89.2% | 89.7% | 92.5% | 94.8% | 93.4% | 89.4% | 89.9% |
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| 10. Supplies/equipment not functioning properly when needed | 78.0% | 86.7% | 83.6% | 77.3% | 84.7% | 84.7% | 86.2% | 91.2% | 89.2% | 83.8% | 84.4% |
| | |||||||||||
| Communication/Teamwork - Overall | 79.2% | 75.2% | 80.2% | 79.1% | 80.0% | 83.0% | 83.5% | 78.3% | 84.4% | 83.1% | 81.7% |
| | |||||||||||
| 5. Unbalanced patient assignments | 91.6% | 82.2% | 87.7% | 89.1% | 88.7% | 91.2% | 94.2% | 85.5% | 95.4% | 91.7% | 91.0% |
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| 7. Inadequate hand-off from previous shift or sending unit | 84.6% | 84.1% | 86.1% | 88.2% | 87.1% | 89.8% | 88.8% | 84.0% | 90.0% | 89.3% | 88.0% |
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| 8. Other departments did not provide the care needed (e.g. physical therapy did not ambulate) | 73.9% | 77.8% | 84.4% | 82.5% | 88.3% | 84.9% | 87.7% | 85.3% | 86.0% | 82.8% | 84.5% |
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| 11. Lack of back up support from team members | 77.0% | 80.0% | 78.4% | 78.0% | 80.5% | 81.1% | 79.5% | 79.5% | 85.0% | 80.2% | 79.9% |
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| 12. Tension or communication breakdowns with other ancillary/support departments | 80.1% | 80.0% | 78.9% | 73.7% | 76.0% | 83.4% | 80.2% | 76.6% | 81.9% | 84.5% | 79.9% |
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| 13. Tension or communication breakdowns within the nursing team | 78.5% | 72.7% | 76.1% | 72.3% | 71.7% | 74.0% | 75.2% | 67.7% | 77.8% | 78.3% | 75.4% |
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| 14. Tension or communication breakdowns with the medical staff | 80.1% | 84.1% | 78.4% | 77.6% | 80.7% | 78.6% | 83.6% | 76.6% | 84.3% | 86.1% | 81.7% |
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| 15. Nursing assistant did not communicate that care was not done | 85.5% | 58.1% | 83.0% | 83.2% | 81.8% | 91.9% | 89.5% | 79.1% | 86.7% | 85.1% | 85.2% |
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| 16. Caregiver off unit or unavailable | 61.7% | 58.1% | 69.1% | 67.3% | 65.0% | 72.3% | 73.2% | 70.8% | 72.3% | 69.6% | 69.8% |