Nurses have a central role in patient safety, as discussed in a previous Patient Safety Primer. There is a well-established link between the adequacy of nurse staffing in hospitals and patient outcomes such as mortality and failure-to-rescue. However, the pathway that connects nurse staffing with patient outcomes is less well understood. One proposed pathway is the amount of surveillance, or ongoing assessment and reassessment of patient condition, that can be provided under a given staffing structure. A related proposed pathway is missed nursing care.
Missed nursing care is a subset of the category known as error of omission. It refers to needed nursing care that is delayed, partially completed, or not completed at all. Missed nursing care is problematic because nurses coordinate, provide, and evaluate many interventions prescribed by others to treat illness in hospitalized patients. Moreover, nurses also plan, deliver, and evaluate nurse-initiated care to manage patients’ symptoms and responses to care, and to promote health and healing. Thus missed nursing care not only constitutes a form of medical error that may affect safety, but has been deemed to be a unique type of medical underuse.
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