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Missed Care from the Patient’s Perspective – A Scoping Review

Authors Gustafsson N, Leino-Kilpi H, Prga I, Suhonen R, Stolt M

Received 10 November 2019

Accepted for publication 20 January 2020

Published 25 February 2020 Volume 2020:14 Pages 383—400

DOI https://doi.org/10.2147/PPA.S238024

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Noora Gustafsson, 1 Helena Leino-Kilpi, 1, 2 Ivana Prga, 3 Riitta Suhonen, 1, 2, 4 Minna Stolt 1, 2 On behalf of the RANCARE consortium COST Action – CA15208

1Department of Nursing Science, University of Turku, Turku, Finland; 2Turku University Hospital, Turku, Finland; 3Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia; 4Welfare Division, Healthcare Services, Turku, Finland

Correspondence: Noora Gustafsson
Department of Nursing Science, 2 University of Turku, Turku 20041, Finland
Tel +358 440 276 600
Email noemgu@utu.fi

Abstract: Missed care, defined as any aspect of patient care that is omitted or delayed, is receiving increasing attention. It is primarily caused by the imbalance between patients’ nursing care needs and the resources available, making it an ethical issue that challenges nurses’ professional and moral values. In this scoping review, conducted using the five-stage approach by Arksey and O’Malley, our aim is to analyze the patients’ perspective to missed care, as the topic has been mainly examined from nurses’ perspective. The search was conducted in April 2019 in PubMed, CINAHL, PsycINFO, Web of Science, ProQuest and Philosophers Index databases using the following terms: omitted care, unfinished nursing care, care undone, care unfinished, missed care, care left undone, task undone and implicit rationing with no time limitation. The English-language studies where missed care was examined in the nursing context and had patients as informants on patient-reported missed care or patients’ perceptions on nurse-reported missed care were selected for the review. Thirteen studies were included and analyzed with thematic content analysis. Twelve studies were quantitative in nature. Patients were able to report missed care, and mostly reported missed basic care, followed by missed communication with staff and problems with timeliness when they had to wait to get the help they needed. In statistical analysis, missed care was associated with patient-reported adverse events and patients’ perceptions of staffing adequacy, and in patients’ perception, it was mainly caused by lack of staff and insufficient experience. Furthermore, patients’ health status, as opposed to gender, predicted missed care. The results concerning patients’ age and education level were conflicting. Patients are able to identify missed care. However, further research is needed to examine patient-perceived missed care as well as to examine how patients identify missed care, and to get a clear definition of missed care.

Keywords: omitted care, care left undone, unmet nursing care needs, patient perceptions

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