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Title: Strategies to prevent missed nursing care: An international qualitative study based upon a positive deviance approach
Authors: Longhini, Jessica 
Papastavrou, Evridiki 
Efstathiou, Georgios 
Andreou, Panayiota 
Stemmer, Renate 
Ströhm, Christina 
Schubert, Maria 
De Wolf-Linder, Susanne 
Palese, Alvisa 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Head nurses;Missed nursing care;Nursing care management;Patient safety;Safety management
Issue Date: Apr-2021
Source: Journal of Nursing Management, 2021, vol. 29, no. 3, pp. 572 - 583
Volume: 29
Issue: 3
Start page: 572
End page: 583
Journal: Journal of Nursing Management 
Abstract: Aim To identify the strategies to prevent missed nursing care (MNC) that can be implemented by nurse managers/directors on a daily basis. Background Only few recommendations have been established to date aiming at supporting nurse managers/ directors in preventing MNC. However, several strategies are implemented on a daily basis, suggesting that a body of tacit, practical and wise knowledge is already in place. Method(s) An international qualitative descriptive study based on the positive deviance approach conducted in 2019−2020 and reported according to the Consolidated Criteria for Reporting Qualitative Research. A purposeful sample of 35 nurse managers/directors working in hospitals in Cyprus, Italy, Germany and Switzerland was involved. Codes were extracted from each country, and a thematic analysis was performed at the transnational level to identify strategies and interventions preformed to prevent MNC. Results Eight strategies and 22 interventions, mainly with preventive intent and designed at the hospital level, affecting both the processes and the structural dimensions, have been reported as effective in preventing MNC. Conclusion Nurse leaders are involved daily in implementing strategies to minimise MNC at the nursing and at the hospital system levels, integrated with each other. Implications for Nursing Management Preventing MNC should be a core value of the entire hospital, and not merely a nursing issue. Therefore, complex interventions at the system level are required.
ISSN: 1365-2834
DOI: 10.1111/jonm.13176
Rights: © Wiley
Attribution-NonCommercial-NoDerivatives 4.0 International
Type: Article
Affiliation : University of Udine 
Cyprus University of Technology 
Ministry of Health 
University of Nicosia 
Catholic University of Applied Sciences 
Zurich University of Applied Sciences 
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