Association between Nursing Communication and Missed Nursing Care by Nurses at University Teaching and Referral Hospital in Rwanda

Faustin Ntezimana *

Mount Kenya University, Kenya.

Nilufa Jivraj

School of Nursing, Mount Kenya University, Kenya.

Mogere Dominic

School of Public Health, Mount Kenya University, Kenya.

*Author to whom correspondence should be addressed.


Abstract

Introduction: Omitting nursing care is a challenging concern in healthcare settings. This concept has not been addressed much, especially in the African context. This missing is related to any prescribed or administered activity by a nurse, omitted, delayed, or left undone. Focusing on identifying them and their associated factors will assist healthcare providers in improving the patient's outcomes.

Objective: The aims of this study was to determine the levels, types and the communication factors that influence missed nursing Care activities by nurses at the University Teaching and Referral Hospital of Kigali in Rwanda. 

Materials and Methods: This study was cross-sectional descriptive correlation design. The study used census method of sampling technique to obtain participants. The researcher used MISSCARE survey questionnaires for data collection. The data were analysed using SPSS version 26.0. Frequencies, percentages, chi-square and multinomial logistic regression were computed to find relationships between independent and dependent variables at 95% confidential interval and significance level of 5%. The results were presented using tables, figures.

Results: Two hundred and one nurses took part in the study, 56.7% were female and 46.3% were male. The majority were aged 31-40 years, 54.2% had Diploma, 42.3% had bachelor while 3.5% had master’s degree, and 75.6% were married. The mean experience in nursing and in current unit were 13years and 7years respectively. The majority (46.73%) responded that missed nursing care was regarded as moderate while 29.65% perceived them as high across the assessed departments. The results also showed that replying to call alarms within 5 minutes (29.9%), joining interdisciplinary whenever held (25.4%), documentation of necessary information (24.9%), monitoring intake and output (21.9%) and patient health education (18.4%) were always being missed by nurses. Chi square test showed that all elements of communication were statistically significant factors associated with level of missed nursing care activities.

Discussion: The finding revealed that the level of missed nursing care at the hospital as moderate and the level of missed nursing care was different across the hospital. The top five nursing activities that have always been missed were replying to call alarms within 5 minutes, joining interdisciplinary whenever held, documentation of necessary information, monitoring intake and output, and patient health education. The findings of the study showed that nursing communication was the main factor influencing missed nursing care.

Conclusions: The study findings showed that level of missed nursing care was moderate and MNC were different across the hospital. It also indicated nursing communication factors were the most significant factors.  The study also highlighted the top five missed nursing care that are perceived to be always missed.

Recommendation:  Ensure that efficient and effective communication among the nurses, medical staff and other stakeholders.

Keywords: Missed care, missed nursing care, nursing communication, missed communication


How to Cite

Ntezimana , Faustin, Nilufa Jivraj, and Mogere Dominic. 2023. “Association Between Nursing Communication and Missed Nursing Care by Nurses at University Teaching and Referral Hospital in Rwanda”. Asian Journal of Research in Nursing and Health 6 (1):80-91. https://journalajrnh.com/index.php/AJRNH/article/view/108.

Downloads

Download data is not yet available.

References

Blackman I, Henderson J, Willis E, Hamilton P, Toffoli L, Verrall C, et al. Factors influencing why nursing care is missed. J Clin Nurs [Internet]. 2015 Jan 1 [cited 2021 Feb 10];24(1–2):47–56. Available: ttp://doi.wiley.com/10.1111/jocn.12688

Avallin T, Muntlin Athlin Å, Björck M, Jangland E. Using communication to manage missed care: A case study applying the Fundamentals of Care framework. In: Journal of Nursing Management [Internet]. Blackwell Publishing Ltd; 2020 [cited 2021 Feb 10]:2091–102. Available:https://pubmed.ncbi.nlm.nih.gov/31985109/

Labrague LJ, De los Santos JAA, Tsaras K, Galabay JR, Falguera CC, Rosales RA, et al. The association of nurse caring behaviours on missed nursing care, adverse patient events and perceived quality of care: A cross-sectional study. In: Journal of Nursing Management. Blackwell Publishing Ltd. 2020:2257–65.

Hernández-cruz R, Moreno-Monsiváis MG, Cheverría-Rivera S, Díaz-Oviedo A. Factors influencing the missed nursing care in patients from a private hospital. Rev Latino-Am Enferm [Internet]. 2017 [cited 2021 Feb 14];25:2877. Available:www.eerp.usp.br/rlaewww.eerp.usp.br/rlae

Gathara D, Serem G, Murphy GA V, Obengo A, Tallam E, Jackson D, et al. Missed nursing care in newborn units : a cross- ­ sectional direct observational study. 2019;19–30.

Moreno-Monsiváis MG, Moreno-Rodríguez C, Interial-Guzmán MG, Guadalupe M, Rodríguez M, Guadalupe M, et al. Missed nursing care in hospitalized patients. Aquichan [Internet]. 2015 Sep 1 [cited 2020 Dec 12];15(3):318–28. Available:http://www.scielo.org.co/scielo.php?script=sci_arttext&pid=S1657-59972015000300002&lng=en&nrm=iso&tlng=en

Ball JE, Bruyneel L, Aiken LH, Sermeus W, Sloane DM, Marie A, et al. Post-operative mortality , missed care and nurse sta ffi ng in nine countries : A Cross-sectional Study; 2017.

Kalisch BJ. Missed Nursing Care , Staffing , and Patient Falls. 2012;27(1):6–12.

Ball JE, Murrells T, Rafferty AM, Morrow E, Griffiths P. Care left undone during nursing shifts: Associations with workload and perceived quality of care. BMJ Qual Saf [Internet]. 2014 Feb 1 [cited 2021 Mar 16];23(2):116–25. Available: http://dx.doi.org/10.1136/bmjqs-

Diab GMAE-H, Ebrahim RMR. Factors Leading to Missed Nursing Care among Nurses at Selected Hospitals. Am J Nurs Res Vol 7, 2019, Pages 136-147 [Internet]. 2019;7(2):136–47. Available: http://pubs.sciepub.com/ajnr/7/2/5/index.ml

Kalisch BJ. Missed nursing care: A qualitative study. J Nurs Care Qual. 2006;21(4):306–13.

Kalisch BJ, Tschannen D, Hee Lee K, Lee KH, Hee Lee K, Lee KH. Do staffing levels predict missed nursing care? Int J Qual Heal Care [Internet]. 2011 Jun 1 [cited 2021 Feb 14];23(3):302–8. Available:https://academic.oup.com/intqhc/article/23/3/302/1792830

Lake ET, Germack HD, Viscardi MK. Missed nursing care is linked to patient satisfaction: A cross-sectional study of US hospitals. BMJ Qual Saf [Internet]. 2016 Jul 1 [cited 2020 Dec 19];25(7):535–43. Available:https://qualitysafety.bmj.com/content/25/7/535

Ball, Griffiths PD. Missed Nursing Care : A Key Measure for Patient Safety. researchgate. 2018;(March).

Kalisch BJ, Tschannen D, Lee H, Friese CR. Hospital variation in missed nursing care. Am J Med Qual [Internet]. 2011 Jul 3 [cited 2020 Dec 19];26(4):291–9. Available:http://journals.sagepub.com/doi/10.1177/1062860610395929

Adindu A. Assessing and Assuring Quality of Health Care in Africa Assessing and Assuring Quality of Health Care in Africa by Anthonia Adindu Department of Public Health College of Medical Sciences , University of Calabar Calabar , Cross River State , Nigeria; 2017.

Mosadeghrad AM. Factors affecting medical service quality. Iran J Public Health [Internet]. 2014 Feb 23 [cited 2020 Dec 19];43(2):210–20. Available: http://ijph.tums.ac.ir

Mebrahtom Haftu, Alem Girmay, Martha Gebremeskel, Gebrekiros Aregawi, Dawit Gebregziabher CR, Haftu M, Girmay A, Gebremeskel M, Aregawi G, Gebregziabher D, et al. Commonly missed nursing cares in the obstetrics and gynecologic wards of Tigray general hospitals ; Northern Ethiopia. PLoS One. 2019;299(12):1–11.

Ramakuela NJ, Mundalamo RN, Ndou ND. Factors affecting quality patient care in paediatric units of Vhembe district, Limpopo Province, South Africa. African J Phys Act Heal Sci [Internet]. 2018 [cited 2020 Dec 19];24(3 Supplementary):16–27. Available:https://www.ajol.info/index.php/ajpherd/article/view/181181

Kalisch BJ, Williams RA. Development and psychometric testing of a tool to measure missed nursing care. J Nurs Adm. 2009;39(5):211–9.

Nelson ST. The relationships among workload, teamwork, and missed nursing care in the nursing home environment. 2017;1–14.

Salwa AM, Abed F. Perception of Teamwork and Missed Nursing Care Among Nurses in Intensive Care Units at South Valley University Hospitals. J Nurs Heal Sci [Internet]. 2016;5(6):89–97. Available:https://translate.google.com/translate?hl=es&sl=en&u=https://pdfs.semanticscholar.org/5cb2/58b9b911f810f0d3b9d138b4bf1715532a5d.pdf&prev=search

Mebrahtom Haftu, Alem Girmay, Martha Gebremeskel, Gebrekiros Aregawi, Dawit Gebregziabher CR. Commonly missed nursing cares in the obstetrics and gynecologic wards of Tigray general hospitals ; Northern Ethiopia. 2019;299:1–11.

Schmidt A. Missed Nursing Care Reported by Medical-Surgical RNs in a Community Hospital Recommended Citation; 2018. Available:https://hsrc.himmelfarb.gwu.edu/son_dnp

Abery E, Honours B, Harvey C. Nurses and midwives perceptions of missed nursing care — A South Australian study. Collegian [Internet]. 2014;

(August). Available:http://dx.doi.org/10.1016/j.colegn.2014.09.001

Bragadóttir H, Kalisch BJ, Tryggvadóttir GB. Correlates and predictors of missed nursing care in hospitals. J Clin Nurs. 2017;26(11–12):1524–34.

Gabr H, El-shaer A, Prof A. Factors Affecting Missed Nursing Care and its Relation toNurses ’ Work Flow in General Medical and Surgical Units. 2020;9(3):21–31.

Kalánková D, Kirwan M, Bartoníčková D, Cubelo F, Žiaková K, Kurucová R. Missed, rationed or unfinished nursing care: A scoping review of patient outcomes. J Nurs Manag. 2020;28(8):1783–97.

Beatrice J. Kalisch AW. Development and psychometric testing of a tool to measure missed nursing care. J Nurs Adm [Internet]. 2009 Aug 27 [cited 2020 Dec 19];39(5):211–9. Available:http://dx.doi.org/10.1016/j.colegn.2014.09.001

Ausserhofer D, Zander B, Busse R, Schubert M, Geest S De, Rafferty AM, et al. Prevalence, patterns and predictors of nursing care left undone in European hospitals: Results from the multicountry cross-sectional RN4CAST study. BMJ Qual Saf. 2014 Feb;23(2):126–35.

Tubbs-Cooley HL, Pickler RH, Mara CA, Othman M, Kovacs A, Mark BA. Hospital Magnet® Designation and Missed Nursing Care in Neonatal Intensive Care Units. J Pediatr Nurs [Internet]. 2017; 34(December):5–9. Available:http://dx.doi.org/10.1016/j.pedn.2016.12.004