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Journal article : Review

Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review

Abstract:
Background
Missed nursing care undermines nursing standards of care and minimising this phenomenon is crucial to maintaining adequate patient safety and the quality of patient care. The concept is a neglected aspect of human resource for health thinking, and it remains understudied in low-income and middle-income country (LMIC) settings which have 90% of the global nursing workforce shortages. Our objective in this review was to document the prevalence of missed nursing care in LMIC, identify the categories of nursing care that are most missed and summarise the reasons for this.
Methods
We conducted a systematic review searching Medline, Embase, Global Health, WHO Global index medicus and CINAHL from their inception up until August 2021. Publications were included if they were conducted in an LMIC and reported on any combination of categories, reasons and factors associated with missed nursing care within in-patient settings. We assessed the quality of studies using the Newcastle Ottawa Scale.
Results
Thirty-one studies met our inclusion criteria. These studies were mainly cross-sectional, from upper middle-income settings and mostly relied on nurses’ self-report of missed nursing care. The measurement tools used, and their reporting were inconsistent across the literature. Nursing care most frequently missed were non-clinical nursing activities including those of comfort and communication. Inadequate personnel numbers were the most important reasons given for missed care.
Conclusions
Missed nursing care is reported for all key nursing task areas threatening care quality and safety. Data suggest nurses prioritise technical activities with more non-clinical activities missed, this undermines holistic nursing care. Improving staffing levels seems a key intervention potentially including sharing of less skilled activities. More research on missed nursing care and interventions to tackle it to improve quality and safety is needed in LMIC.
PROSPERO registration number: CRD42021286897.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1186/s12960-023-00807-7

Authors


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Role:
Author
ORCID:
0000-0001-5070-3060
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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Role:
Author
ORCID:
0000-0001-6874-8929


Publisher:
BioMed Central
Journal:
Human Resources for Health More from this journal
Volume:
21
Issue:
1
Article number:
19
Place of publication:
England
Publication date:
2023-03-14
Acceptance date:
2023-02-23
DOI:
EISSN:
1478-4491
Pmid:
36918941


Language:
English
Keywords:
Subtype:
Review
Pubs id:
1333835
Local pid:
pubs:1333835
Deposit date:
2023-06-21

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