Missed nursing care in emergency departments: a cross-sectional descriptive study

Rooddehghan, Zahra; Karimi, Hamid; Mohammadnejad, Esmaeil; Sayadi, Leila; Haghani, Shima; Karimi, Raoofeh

doi:10.1186/s12873-024-00936-9

BMC Emergency Medicine

Table 2 Frequency distribution of missed nursing care in different areas in the emergency departments of selected hospitals of Tehran University of Medical Sciences-2020

From: Missed nursing care in emergency departments: a cross-sectional descriptive study

Areas^b			Total number of observations^c	Done^d (1)	Not done^e (0)	Not necessary^f (1)	Mean (SD^a)
Areas^b	No	Items	Total number of observations^c	Frequency (%)	Frequency (%)	Frequency (%)	Mean (SD^a)
The area of triage^g	1	It is performed by a nursing expert with at least 5 years of clinical work experience, of which at least one year is in the emergency department^g.	384	384 (100)	0 (0)	0 (0)	2 (0)
	2	It takes place upon arrival to emergency department and even before admission and payment.	384	384 (100)	0 (0)	0 0	2 (0)
	3	The triage nurse’s evaluation of second level patient is done less than 5 min after the patient’s entry to emergency room	384	31 (8.1)	26 (6.8)	327 (85.2)	1.01 (0.38)
The area of physiological monitoring	1	Blood pressure is controlled	384	281 (37.2)	84 (21.9)	19 (4.9)	1.51 (0.83)
The area of physiological monitoring	2	The temperature is measured	384	209 (54.4)	164 (42.7)	11 (2.9)	1.11 (0.97)
The area of implementing orders	1	Requested tests are sent	384	280 (72.9)	73 (19)	31 (8.1)	1.53 (0.79)
The area of implementing orders	2	When giving medication to patients, the correct medication process is observed	384	172 (44.8)	212 (55.2)	0 (0)	0.89 (0.99)
The area of patient’s condition	1	When the patient is in bed, the bedrails are up	384	184 (47.9)	198 (51.6)	2 (0.5)	0.96 (0.99)
The area of patient’s condition	2	The results of tests are followed up	384	325 (84.6)	57 (14.9)	2 (0.5)	1.69 (0.71)
The area of patient communication	1	The nurse establishes effective and reassuring communication with the patient	384	189 (49.2)	195 (50.8)	0 (0)	0.89 (1)
The area of patient communication	2	The nurse teaches the patient the minimum items to be taught to the patient during hospitalization	384	199 (51.8)	116 (30.2)	69 (18)	1.21 (0.88)
The area of infection control and environmental health	1	After contact with body fluids and secretions of the patient, the nurse washes her hands	384	358 (93.2)	26 (6.8)	0 (0)	1.86 (0.5)
The area of infection control and environmental health	2	The nurse observes the principles of sterilization in sterile procedures	384	169 (44)	203 (52.9)	12 (3.1)	0.91 (0.98)
The area of making decision about patient	1	The nurse performs the necessary follow-up to determine the patient’s condition	384	301 (78.4)	80 (20.8)	3 (0.8)	1.57 (0.81)
	2	Proper coverage and privacy of the patient is observed during the transfer	384	292 (76)	71 (18.5)	21 (5.5)	1.57 (0.78)
	3	The schedule informs the patient/family about the scheduled visits after discharge	384	89 (23.2)	80 (20.8)	215 (56)	1.02 (0.66)
The area of registration	1	The nursing report is recorded with a blue or black pen	384	377 (98.2)	7 (1.8)	0 (0)	1.96 (0.26)
The area of registration	2	No nursing action is recorded before it is performed	384	94 (24.5)	290 (75.5)	0 (0)	0.48 (0.86)
The area of cardiopulmonary resuscitation	1	The team/resuscitation room nurse is aware of her roles and duties and is actively present	384	297 (77.3)	57 (14.8)	30 (7.8)	1.62 (0.72)
The area of cardiopulmonary resuscitation	2	The nurse of the resuscitation team has attached the resuscitation code card, which shows the description of duties, to the patient’s chest	384	44 (11.5)	114 (29.7)	226 (58.9)	0.81 (0.61)
The area of checking equipment and emergency trolley	1	The emergency trolley is continuously managed and updated by the responsible nurse in each work shift	384	180 (46.9)	77 (20.1)	127 (33.1)	1.26 (0.77)
	2	The arrangement of medications and equipment in the resuscitation trolley is done according to the latest instructions issued by the Ministry of Health	384	384 (100)	0 (0)	0 (0)	2 (0)
	3	It is possible to have easy, immediate and unhindered access to the resuscitation trolley within a minute	384	384 (100)	0 (0)	0 (0)	2 (0)
The area of patient transfer	1	The patient’s identification wristband and all treatment accessories are checked by the nurse in terms of correctness	384	187 (48.7)	170 (44.3)	27 (7)	1.04 (0.96)
The area of patient transfer	2	The nurse describes the current condition of the patient within 5 to 10 s	384	313 (81.5)	71 (18.5)	0 (0)	1.63(0.77)

^aSD Standard Deviation
^bIt represents all the work areas that exist in the emergency department (11 areas) and each area includes several activities, in this table only the most and the least missed nursing care in that work area is stated
^cIt shows the number of times each care was observed in each area in the emergency department
^dNumber of times each care was performed and not missed
^eNumber of times each care was missed
^fThe number of times that it was not necessary to perform this care
^gFor example, this area has been observed 384 times, and regarding activities “It is performed by a nursing expert with at least 5 years of clinical work experience, of which at least one year is in the emergency department” and “It takes place upon arrival to emergency department and even before admission and payment.” 384 times out of 384 observations were made and not missed, 26 times out of 384 observations were missed in” The triage nurse’s evaluation of second level patient is done less than 5 min after the patient’s entry to emergency room”

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ISSN: 1471-227X

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