Are data on missed nursing care useful for nursing leaders? The RN4CAST@IT cross-sectional study.

Aim: To describe nurses' reported missed nursing care activities among hospitalized adult patients medical and surgical wards and explore gaps in service provision.
Background: In 2015, Italy replicated the RN4CAST study, which heralded the exposition of missed care as an international phenomenon. In Italy, nurse-patient workload is high, with high levels of burnout and dissatisfaction reported, all factors associated with missed care.
Methods: A cross-sectional study (n = 3,590) was conducted using the 13-item online Task Left Undone Tool aimed at collecting data on missed nursing care.
Results: The frequency of omission of activities ranged between 7% and 50%. There were significant differences between morning, afternoon and night shifts and the various clinical settings. Oral care was the most frequently missed care activity.
Conclusions: This study takes step forward in identifying and reducing missed care on medical and surgical wards, both in Italy and also internationally, which needs to take into account the specific organisational characteristics of each setting.
Implications for Nursing Management: Although more essential activities are missed less frequently, much is known about the relational deficits such as information giving, education, communication and discharge advice, which managers ought to spearhead through local initiatives to improve these practices.
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