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Title: Developing policies and actions in response to missed nursing care: A consensus process
Authors: Palese, Alvisa 
Bassi, Erika 
Tommasini, Cristina 
Vesca, Roberta 
Di Falco, Achille 
De Lucia, Paola 
Mulloni, Giovanna 
Paoletti, Flavio 
Rissolo, Raffaela 
Sist, Luisa 
Sanson, Gianfranco 
Guardini, Ilario 
Bressan, Valentina 
Mesaglio, Maura 
Papastavrou, Evridiki 
Blackman, Ian 
Major Field of Science: Medical and Health Sciences
Field Category: Health Sciences
Keywords: Consensus development process;Implementation process;Missed nursing care;Policy;Rationing of nursing care;Tasks left undone
Issue Date: Oct-2019
Source: Journal of Nursing Management, 2019, vol. 27, no. 7, pp. 1492-1504
Volume: 27
Issue: 7
Start page: 1492
End page: 1504
Journal: Journal of Nursing Management 
Abstract: Aim: To support the development of appropriate policies and actions in the field of missed nursing care (MNC). Background: There has been an ever-growing international debate on MNC, interventions that nurses have identified as necessary for their patients, but which for various reasons they are unable to provide or are forced to delay. Despite MNC's relevance, its translation into policies and actions has not been documented to date. Method: A consensus development method was employed involving (a) a nominal group composed of experts in the field, policymakers and the President of the Regional Nursing Professional Boards, and (b) 218 nurses appointed primarily at the managerial levels. Results: A total of eight consensus statements were approved and organized in a series of sub-statements designed to (1) render the concept of MNC culturally acceptable in the Italian context, with the agreement that compromised nursing care (CNC) is the best term to be used in this field, as a synonym for MNC; (2) measure CNC as a strategy to increase patient safety; (3) select an appropriate CNC measurement tool; (4) optimize CNC measurement; (5) conduct effective CNC data analysis; (6) design and implement interventions to prevent and/or minimize CNC; (7) assess and disseminate findings on interventions' effectiveness; and (8) provide final remarks on the way to move forward. Conclusions: We developed a process to introduce the phenomenon of MNC in the Italian culture and agreed firstly on the term compromised nursing care, which better reflects MNC's meaning according to the context and facilitates an open discussion on the phenomenon both within and outside the profession. The following consensus statements emerged represent a systematic approach, starting from the measurement and finishing with the re-measurement of the occurrence of MNC after having implemented concrete actions. Implications for Nursing Management: The approved consensus statements can guide decision-makers to develop concrete policies and actions that promote the improvement of quality of care and patients' safety by minimizing and/or preventing MNC's occurrence.
ISSN: 1365-2834
DOI: 10.1111/jonm.12835
Rights: © Wiley
Attribution-NonCommercial-NoDerivs 3.0 United States
Type: Article
Affiliation : University of Udine 
University of Tor Vergata 
Azienda Sanitaria Universitaria Integrata di Udine 
Azienda Zero Regione del Veneto 
Ordine Professioni Infermieristiche 
Universitaria Integrata di Trieste 
University of Trieste 
University of Bologna 
Cyprus University of Technology 
Flinders University 
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