AHRQ ( 2019 ) says that missed nursing care is a subset of the category known as error of omission and that it “ not only constitutes a form of medical error that may affect safety , but has been deemed to be a unique type of medical underuse .” monitoring as prescribed by the physician was reported as often / sometimes missed by 17 percent of nurses .”

Causes of Missed Nursing Care

In their review , Chaboyer , et al . ( 2020 ) identified factors that influence missed nursing care , including staffing levels and / or labor resources , skill mix , material resources not being available , patient acuity and teamwork / communication .

These factors are echoed by Kalisch and colleagues , who developed a conceptual model of missed nursing care , outlining the structural factors contributing to missed nursing care as labor resources ( number and types of nursing staff , competency level of nursing staff , education and experience of staff ; material resources ( availability of necessary medications , supplies , and equipment ); and teamwork and communication ( among the patient-care team members , between nurses and physicians , between nurses and support staff ).

“ When one or more of these resources is missing from an organization or during a work period , nurses need to prioritize their care activities and the stage is set for nursing care to be delayed or omitted ,” according to the Agency for Healthcare Research and Quality ( AHRQ , 2019 ).

In Kalisch ’ s model , a nurse faced with restricted resources uses the nursing process to determine clinical priorities and make decisions about whether to delay or omit certain aspects of care . The decision process is influenced by four individual-level factors : The nurse ’ s perceptions of team or group norms ; the nurse ’ s judgment about the importance of various aspects of care relative to the conditions of multiple patients the nurse may be responsible for ; the nurse ’ s values , attitudes , and beliefs ; and the nurse ’ s usual practice . The outcome of the clinical prioritization process in the face of resource or time scarcity is missed nursing care .

AHRQ ( 2019 ) says that “ The more routine consequences of missed nursing care can include delayed or omitted medications or treatments ; complications such as atelectasis , deconditioning , pressure ulcers , falls , ventilator-associated pneumonia , or other nosocomial infections ; increased length of stay ; and decreased patient satisfaction . Kalisch ’ s model also implies that organizational conditions can promote normalization of deviance — even when missed nursing care does not result in observable adverse effects . The experience of working under time and resource pressure can unconsciously reinforce the acceptability of delaying or omitting care , leading to missed care becoming routine .”

In their study , Jones , et al . ( 2015 ) discovered that “ Patterns of unfinished care were consistent with

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