Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
REVIEW (Open Access)

An integrative review of missed nursing care and the general practice nurse

Eileen Willis A B , Claire Verrall https://orcid.org/0000-0001-5557-7067 C * , Susan McInnes D and Elyce Pate C
+ Author Affiliations
- Author Affiliations

A Central Queensland University, School of Nursing, Midwifery and Social Sciences, Rockhampton, Qld, Australia.

B Flinders University of South Australia, College of Nursing and Health Sciences, Sturt Road, Bedford Park, SA 5042, Australia.

C The University of Adelaide School of Nursing, Level 4 Adelaide Health and Medical Sciences Building, Corner North Terrace and George Street, Adelaide, SA 5005, Australia.

D The University of Wollongong, Northfields Avenue, Wollongong, NSW 2522, Australia.

* Correspondence to: claire.verrall@adelaide.edu.au

Australian Journal of Primary Health 30, PY23127 https://doi.org/10.1071/PY23127
Submitted: 17 July 2023  Accepted: 16 January 2024  Published: 6 February 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of La Trobe University. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Background

The phenomenon of missed care has received increasing interest over the past decade. Previous studies have used a missed care framework to identify missed nursing tasks, although these have primarily been within the acute care environment. The aim of this research was to identify missed care specific to the role of the general practice nurse.

Methods

An integrative review method was adopted, using The Mixed Methods Appraisal Tool to assist in a methodological appraisal of both experimental, theoretical, and qualitative studies. Thematic analysis was then used to analyse and present a narrative synthesis of the data. Data sources: CINAHL, SCOPUS, Web of Science and Google Scholar databases were searched between 2011 and 2022 for empirical research that reported missed care and the general practice nurse.

Results

Of the 787 papers identified, 10 papers met the inclusion criteria. Three themes identified missed care in relation to primary healthcare nurses: under-staffing and resourcing, communication difficulties, and role confusion.

Conclusion

Isolating missed care by general practice nurses was challenging because much of the research failed to separate out general practice nurses from community and primary health care nurses. This challenge was exacerbated by disparity in the way that a general practice nurse is defined and presented in the various databases. While some themes such as those related to communication and understaffing and resourcing demonstrate some parallels with the acute sector, more research is required to identify missed care specific to the general practice nurse.

Keywords: clinic, community, family practice, general practice, missed care, practice nurse, primary care, primary health care.

References

ACN (2019) A New Horizon for Health Service: Optimising Advanced Practice Nursing A white paper by CAN 2019, Australian College of Nursing, Canberra.

Blackman I, Henderson J, Willis E, Hamilton P, Toffoli L, Verrall C, Abery E, Harvey C (2014) Factors influencing why nursing care is missed. Journal of Clinical Nursing 24(1–2), 47-56.
| Crossref | Google Scholar | PubMed |

Blackman I, Henderson J, Willis E, Toffoli L (2015) After hours nurse staffing, work intensity and quality of care-missed care study: New South Wales, Final report to the Australian Nursing and Midwifery Federation New South Wales. Flinders University, Adelaide.

Blackman I, Palese A, Davielis M, Vryonides S, Henderson J, Willis E, Papastavrou E (2020a) Why nursing care is missed? Findings of a bilateral study. Reasons of Missed Nursing Care. Igiene e Sanita Pubblica 76(6), 355-369.
| Google Scholar | PubMed |

Blackman I, Henderson J, Weger K, Willis E (2020b) Causal links associated with missed residential aged care. Journal of Nursing Management 28(8), 1909-1917.
| Crossref | Google Scholar | PubMed |

Bragadóttir H, Kalisch B, Brergthoora G (2016) Correlates and predictors of missed nursing care in hospitals. Journal of Clinical Nursing 26(11–12), 1524-1534.
| Crossref | Google Scholar | PubMed |

Braun V, Clarke V (2006) Using thematic analysis in psychology. Qualitative Research in Psychology 3(2), 77-101.
| Crossref | Google Scholar |

Buchini S, Quattrin R (2012) Avoidable interruptions during drug administration in an intensive rehabilitation ward: improvement project. Journal of Nursing Management 20(3), 326-334.
| Crossref | Google Scholar | PubMed |

Castner J, Wu YWB, Dean-Baar S (2014) Multi-level model of missed nursing care in the context of hospital merger. Western Journal of Nursing Research 37(4), 441-461.
| Crossref | Google Scholar | PubMed |

Chiappinotto S, Papastavrou E, Efstathiou G, Andreou P, Stemmer R, Ströhm C, Schubert M, de Wolf-Linder S, Longhini J, Palese A (2022) Antecedents of unfuinished nursing care: a systematic review of the literature. BMC Nursing 21(1), 137-160.
| Crossref | Google Scholar | PubMed |

Cho SH, Kim YS, Yeon KN, You SJ, Lee ID (2015) Effects of increasing nurse staffing on missed nursing care. International Nursing Review 62(2), 267-274.
| Crossref | Google Scholar | PubMed |

Dabney B, Kalisch B (2015) Nurse staffing levels and patient-reported missed nursing care. Journal of Nursing Care Quality 30(4), 306-312.
| Crossref | Google Scholar | PubMed |

Dehghan-Nayeri N, Shali M, Navabi N, Ghaffari F (2018) Perspectives of oncology unit nurse managers on missed nursing care: a qualitative study. Asia-Pacific Journal of Oncology Nursing 5(3), 327-336.
| Crossref | Google Scholar | PubMed |

Doherty AJ, Atherton H, Boland P, Hastings R, Hives L, Hood K, James-Jenkinson L, Leavey R, Randell E, Reed J, Taggart L, Wilson N, Chauhan U (2020) Barriers and facilitators to primary health care for people with intellectual disabilities and/or autism: an integrative review. BJGP Open 4(3), bjgpopen20X101030.
| Crossref | Google Scholar | PubMed |

Dowling M, Beauchesne M, Farrelly F, Murphy K (2013) Advanced practice nursing: a concept analysis. International Journal of Nursing Practice 19, 131-140.
| Crossref | Google Scholar | PubMed |

Drach-Zahavy A, Srulovici E (2019) The personality profile of the accountable nurse and missed nursing care. Journal of Advanced Nursing 75, 368-379.
| Crossref | Google Scholar | PubMed |

Ebright PR (2010) The complex work of RNs: implications for healthy work environments. OJIN: The Online Journal of Issues in Nursing 15(1), Manuscript 4.
| Crossref | Google Scholar |

Gaffney T, Hatcher B, Milligan R (2016) Nurses role in medical error recovery: an integrative review. Journal of Clinical Nursing 25, 906-917.
| Crossref | Google Scholar |

Gittner LAS, Husaini BA, Hull PC, Emerson JS, Tropez-Sims S, Reece MC, Zoorob R, Levine RS (2015) Use of six sigma for eliminating missed opportunities for prevention services. Journal of Nursing Care Quality 30(3), 254-260.
| Crossref | Google Scholar | PubMed |

Guzys D, Brown R, Halcomb E, Whitehead D (2021) ‘An introduction to Community and Primary Health Care.’ (Cambridge University Press: Victoria, Australia)

Haddaway NR, McGuinness LA, Pritchard CC (2021) PRISMA 2020: R package and ShinyApp for producing PRISMA 2020 compliant flow diagrams. (Zenodo). doi:10.5281/zenodo.4287834

Halcomb E, Fernandez R, Ashley C, McInnes S, Stephen C, Calma K, Mursa R, Williams A, James S (2021) The impact of COVID-19 on primary health care delivery in Australia. Journal of Advanced Nursing 78(5), 1327-1336.
| Crossref | Google Scholar | PubMed |

Hong QN, Pluye P, Fàbregues S, Bartlett G, Boardman F, Cargo M, Dagenais P, Gagnon M, Griffiths F, Nicolau B, O’Cathain A, Rousseau M-C, Vedel I (2018) Mixed Methods Appraisal Tool (MMAT), version 2018. Registration of Copyright (# 1148552). Available at http://mixedmethodsappraisaltoolpublic.pbworks.com/w/file/fetch/127916259/MMAT_2018_criteria-manual_2018-08-01_ENG.pdf

Kalisch B (2006) Missed nursing care: a qualitative study. Journal of Nursing Care Quality 21(4), 306-313.
| Crossref | Google Scholar | PubMed |

Kalisch B, Kyung HL (2010) The impact of teamwork on missed nursing care. Nursing Outlook 58(5), 233-241.
| Crossref | Google Scholar | PubMed |

Kalisch BJ, Landstrom GL, Hinshaw AS (2009) Missed nursing care: a concept analysis. Journal of Advanced Nursing 65(7), 1509-1517.
| Crossref | Google Scholar | PubMed |

Labrague LJ, de los Sanots JAA, Fronda DC (2022) Factors associated with missed nursing care and nurse-assessed quality of care during the COVID-19 pandemic. Journal of Nursing Management 30(1), 62-70.
| Crossref | Google Scholar | PubMed |

Litchfield IJ, Bentham LM, Lilford RJ, Greenfield SM (2014) Test result communication in primary care: clinical and office staff perspectives. Family Practice 31(5), 592-597.
| Crossref | Google Scholar | PubMed |

Lubbe W, Ham-Baloyi W, Smit K (2020) The integrative literature review as a research method: a demonstration review of research on neurodevelopmental supportive care in preterm infants. Journal of Neonatal Nursing 26(6), 308-315.
| Crossref | Google Scholar |

Ludlow K, Churruca K, Mumford V, Ellis LA, Braithwaite J (2020) Staff members’ prioritisation of care in residential aged care facilities: a Q methodology study. BMC Health Service Research 20, 423.
| Crossref | Google Scholar | PubMed |

Madahar M (2015) Nurse practitioners and practice nurses: different skills, different roles, and both valuable primary care resources. Available at https://www.croakey.org/nurse-practitioners-and-practice-nurses-different-skills-different-roles-and-both-valuable-primary-care-resources/

McInnes S, Peters K, Bonney A, Halcomb E (2015) An integrative review of facilitators and barriers influencing collaboration and teamwork between general practitioners and nurses working in general practice. Journal of Advanced Nursing 71(9), 1973-1985.
| Crossref | Google Scholar | PubMed |

McInnes S, Halcomb E, Ashley C, Kean A, Moxham L, Patterson C (2022) An integrative review of primary health care nurses’ mental health knowledge gaps and learning needs. Collegian 29(4), 540-548.
| Crossref | Google Scholar | PubMed |

Moura ECC, Lima MB, Peres AM, Lopez V, Batista MEM, Braga FDCSAG (2020) Relationship between the implementation of primary nursing model and the reduction of missed nursing care. Journal of Nursing Management 28, 2103-2112.
| Crossref | Google Scholar |

Palese A, Ambrosi E, Prosperi L, Guarnier A, Barelli P, Zambiasi P, Allegrini E, Bazoli L, Casson P, Marin M, Padovan M, Picogna M, Taddia P, Salmaso D, Chiari P, Marognolli O, Canzan F, Gonella S, Saiani L (2015) Missed nursing care and predicting factors in the Italian medical care setting. Internal and Emergency Medicine 10(6), 693-702.
| Crossref | Google Scholar | PubMed |

Papastavrous E, Leino-Kilpi H, 27 European Partners (2016) Rationing - Missed Nursing care: An international and multidimensional problem (CA15208) [Grant]. Europe, USA, Australia, New Zealand, Canada and Israel.

Phelan A, McCarthy S (2016) Missed Care: Community Nursing in Ireland. University College Dublin and the Irish Nurses and Midwives Organisation, Dublin. Available at https://www.justeconomics.co.uk/uploads/reports/Just-Economics-Missed-Care-in-the-Community-Report.pdf

Phelan A, McCarthy S, Adams E (2017) Examining missed care in community nursing: a cross section survey design. Journal of Advanced Nursing 74(3), 626-636.
| Crossref | Google Scholar | PubMed |

Phelan A, McCarthy S, Adams E (2018) Examining the context of community nursing in Ireland and the impact of missed care. British Journal of Community Nursing 23(1), 34-40.
| Crossref | Google Scholar | PubMed |

Poghosyan L, Norful AA, Fleck E, Bruzzese JM, Talsma AN, Nannini A (2017) Primary care providers’ perspectives on errors of omission. Journal of the Americian Board of Family Medicine 30(6), 733-742.
| Crossref | Google Scholar | PubMed |

Schubert M, Glass TR, Clarke SP, Aiken LH, Schaffert-Witvliet B, Sloane DM, De Geest S (2008) Rationing of nursing care and its relationship to patient outcomes: swiss extension of the International Hospital Outcomes Study. International Journal for Qualilty in Health Care 20(4), 227-237.
| Crossref | Google Scholar | PubMed |

Schubert M, Clarke SP, Glass TR, Schaffert-Witvliet B, De Geest S (2009) Indentifying thresholds for relationships between the impact of rationing of nursing care and nurse- and patient-reported outcomes in Swiss hospitals: a correlation study. International Journal of Nursing Studies 46, 884-893.
| Crossref | Google Scholar |

Schubert M, Ausserhofer D, Desmedt M, Schwendimann R, Lesaffre E, Li B, De Geest S (2013) Levels and correlates of implicit rationing of nursing care in Swiss acute care hospitals–a cross sectional study. International Journal of Nursing Studies 50, 230-239.
| Crossref | Google Scholar | PubMed |

Senek M, Robertson S, Ryan T, Sworn K, King R, Wood E, Tod A (2020) Nursing care left undone in community settings: results from a UK cross-sectional survey. Journal of Nursing Management 28, 1968-1974.
| Crossref | Google Scholar | PubMed |

Senek M, Robertson S, Ryan T, Tod A, King R, Wood E, Taylor B (2021) Missed care in community and primary care. Primary Health Care 32(2), e1692.
| Crossref | Google Scholar |

Stephen C, McInnes S, Halcomb E (2018) The feasibility and acceptability of nurse-led chronic disease management interventions in primary care: an integrative review. Journal of Advanced Nursing 74(2), 279-288.
| Crossref | Google Scholar | PubMed |

Tubbs-Cooley HL, Pickler RH, Mark BA, Carle AC (2015) A research protocol for testing relationships between nurse workload, missed nursing care and neonatal outcomes: the neonational nursing care quality study. Journal of Advanced Nusing 71(3), 632-641.
| Crossref | Google Scholar |

Verrall C, Abery E, Harvey C, Henderson J, Willis E, Hamilton P, Toffoli L, Blackman I (2015) Nurses and midwives perceptions of missed nursing care – a South Australian study. Collegian 22(4), 413-420.
| Crossref | Google Scholar | PubMed |

Verrall C, Willis E, Henderson J (2023) Practice nursing: a systematic literature review of facilitators and barriers in three countries. Collegian 30(2), 254-263.
| Crossref | Google Scholar |

Vázquez-Sánchez MA, Jiménez-Arcos M, Aguilar-Trujillo P, Guardiola-Cardenas M, Damián-Jiménez F, Casals C (2020) Characteristics of recovery from near misses in primary health care nursing: a prospective descriptive study. Jounral of Nursing Management 28, 2007-2016.
| Crossref | Google Scholar | PubMed |

Whittemore R, Knafl K (2005) The integrative review: updated methodology. Journal of Advanced Nursing 52(5), 546-553.
| Crossref | Google Scholar | PubMed |

Zelenikova R, Drach Zahavy A, Gurkiva E, Papastavrou E (2019) Understanding the concept of missed nursing care from a cross-cultural perspective. Jounral of Advanced Nursing 2995-3005.
| Crossref | Google Scholar | PubMed |

Zuniga F, Ausserhofer D, Hamers JPH, Engberg S, Simon M, Schwendimann R (2015) The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes–a cross-sectional study. International Journal of Nursing Studies 52(9), 1463-1474.
| Crossref | Google Scholar | PubMed |