INQRI grantee Patti Hamilton recently had the opportunity to present on missed care and off-peak work environments to the Australian Nurse and Midwifery Federation. The findings are the result of a joint study with Midwestern State University and Flinders University. It is an international extension of Dr. Hamilton's INQRI study, "The Effect of Off-peak Hospital Environments on Nurses' Work: an Institutional Ethnography."
The research team interviewed 354 nurses and midwives in Australia using Kalisch's MISSCARE instrument to determine which items of care were commonly missed and to understand why. Respondents noted a wide range of "missed care" items, including: bathing patients, providing adequate discharge information, handwashing, patient education, and much more. Perceived reasons for these omissions included: communications challenges, inadequate hand-offs and number of staff, heavy admission and discharge needs, and more.
Similar to the results of Hamilton's original INQRI study with Dr. Gretchen Gemeinhardt, more issues occurred during "off-peak" shifts.
The MSU-Flinders team also found results similar to those identified in another INQRI study, conducted by Dr. Sue Letvak and Christopher Ruhm, "The Effects of Nurse Presenteeism on Quality of Care and Patient Safety." Letvak and Ruhm found that nurse "presenteeism" (nurses working when sick) was significantly associated with patient falls, medication errors and the perceived quality of care. Hamilton and her colleagues at Flinders found that the number of shifts worked by nurses who were sick or fatigued related to the total number of missed care items reported.
Congratulations to Dr. Hamilton and her colleagues, Eileen Willis (principal investigator), Julie Henderson, Claire Verrall, Clare Harvey, Liz Abery, Luisa Toffoli, and Ian Blackman on this important work!