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J Nurs Manag. 2020 Feb 3. doi: 10.1111/jonm.12969. [Epub ahead of print]

A systematic review of the impact of 'missed care' in primary, community and nursing home settings.

Author information

1
Research Associate in Systematic Revewing, HEDS, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, United Kingdom.
2
Reader in Evidence Based Information Practice, HEDS, School of Health and Related Research, University of Sheffield, Sheffield, United Kingdom.

Abstract

AIM:

To explore "missed care" in relation to primary and community care, including nursing homes to build an understanding of implications for patients, public, politicians and policy makers.

BACKGROUND:

Missed care occurs when any aspect of required patient care is omitted or delayed. Little attention has examined missed care in primary, community and nursing home settings.

DATA SOURCES:

PubMed, CINAHL, Google Scholar (July 2018).

RESULTS:

The search identified 15 metrics papers (2004-2019) and 8 empirical papers (2015-2018) (5 studies) Empirical studies were rated as good quality. Missed care impacts on safety in community/primary care contexts and differs from acute care. Causes of missed care include acuity, complexity of cases, volume of care, organisational factors.

KEY ISSUE:

Metrics have been adapted to community/nursing home contexts but in a non-standardised way. Tools are required to evaluate missed care within a culture of personal reflection and quality improvement.

CONCLUSION:

The prominence of missed acute care should not distract from its impact in primary, community care and nursing home settings. Nurse leaders should consider causes for missed care, how it is conceptualised and evaluated.

IMPLICATIONS FOR NURSING MANAGEMENT AND LEADERSHIP:

This review offers evidence for exploring, measuring and evaluating missed care locally.

KEYWORDS:

evaluation; metrics; missed care; nursing homes; primary care

PMID:
32017305
DOI:
10.1111/jonm.12969

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