A qualitative descriptive inquiry of the influences on nurses’ missed care decision‐making processes in acute hospital paediatric care

• Published in: Journal of nursing management Vol. 28; no. 8; pp. 1929 - 1939
• Main Authors: Bagnasco, Annamaria, Dasso, Nicoletta, Rossi, Silvia, Timmins, Fiona, Aleo, Giuseppe, Catania, Gianluca, Zanini, Milko, Sasso, Loredana
• Format: Journal Article
• Language: English
• Published: England Hindawi Limited 01-11-2020
• Subjects: Caregivers; Children; Clinical nursing; Clinical outcomes; decision‐making; Health status; missed nursing care; Nurses; Nursing; Nursing administration; Organizational culture; paediatric nurse; patient care planning; Pediatric nurses; Pediatrics; paediatric nurse; missed nursing care; patient care planning; decision-making
• ISSN: 0966-0429; 1365-2834
• DOI: 10.1111/jonm.12935

Aim
To explore influences on nurses’ missed care decision‐making processes in acute hospital paediatric care.
Background
Many contemporary studies describe the phenomenon of missed care. It is clear that environment and organizational culture influence the nursing activities; however, what influences their decision‐making processes has not been investigated.
Method
A descriptive qualitative inquiry was performed using semi‐structured interviews with paediatric nurses (n = 20) from one Italian paediatric hospital.
Findings
Thematic analysis revealed four themes: nurses’ value system; hospital logistics, structures and resources; prioritization processes; and the informal caregiver's role.
Conclusion
This paper offers insights into the various factors involved in nurses’ decision‐making process when contemplating missed care that will be of use to managers when planning care or addressing missed care in the paediatric clinical setting.
Implications for Nursing Management
Knowledge and awareness of missed care in children's nursing needs greater exploration, especially in relation to what influences nurses’ decision‐making choices around missed care. Overall, a greater understanding of this will help managers to manage situations effectively and ethically so that missed care does not impact on outcomes for children in health care.