In the fast-paced environment of acute care hospitals, healthcare professionals often face the challenge of prioritizing tasks, sometimes leading to what is known as “unfinished care.” This concept, also referred to by several Care Synonyms such as missed care, implicitly rationed care, and care left undone, represents a significant concern in the delivery of quality patient care. A comprehensive review aimed to delve into these varying terminologies and frameworks surrounding unfinished care, examining how it is measured, its prevalence, contributing factors, consequences, and potential interventions.
This analysis synthesized findings from 54 relevant studies identified through a thorough literature search across CINAHL and MEDLINE databases. The research landscape predominantly features quantitative observational studies using surveys for data collection. Across these studies, a consistent finding emerges: a significant majority of nursing staff, ranging from 55% to 98%, report leaving some aspect of patient care incomplete. The reported rates of unfinished care fluctuate based on factors like survey length, the time frame participants are asked to recall, the breadth of care activities considered, and perceptions of resource limitations. Notably, tasks related to patient education and emotional support are frequently reported as unfinished, often taking a backseat to immediate physiological needs and administrative demands.
Several factors consistently predict the occurrence of unfinished care. These include the quality of teamwork and communication among healthcare providers, the perceived adequacy of resources available, the overall safety climate within the healthcare setting, and nurse staffing levels. Importantly, unfinished care has been shown to negatively impact various outcomes. It is associated with lower nurse-reported quality of care, reduced patient satisfaction, a higher incidence of adverse events, increased nurse turnover rates, decreased job satisfaction, and a greater likelihood of nurses intending to leave their positions.
In conclusion, unfinished care is a widespread issue in hospitals globally, highlighting a critical need for attention. The prioritization processes in place often leave patients vulnerable in terms of their educational, emotional, and psychological well-being. Future research should address limitations such as potential biases in self-reported data, lack of transparency in data analysis, inconsistencies in reporting prevalence, and a scarcity of studies evaluating interventions to mitigate unfinished care. Addressing these gaps is crucial to developing effective strategies for ensuring comprehensive and complete patient care.
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