The Longitudinal Prevalence of Unfinished Nursing Care at the US Army Burn Center
Abstract
Purpose: To identify the prevalence and patterns of unfinished nursing care (UNC) in relation to variations in nursing staff supply and working conditions at the US Army Burn Center. Design: Repeated measures, descriptive design. Methods: Monthly, for six months, registered and licensed vocational nurses completed a 50-item, paper survey. Administrative data related to nursing staff supply and working conditions also were collected monthly from local nurse leaders. Sample: In total, 599 surveys were handed out to 118 nurses; 269 useable surveys were returned (overall response rate of 44.9%, range = 37.9% -51.0%). A total of 95 unique participants were identified, indicating that 80.5% of all eligible nurses participated at least once. Sixty-five (55.1%) participated more than once; 55 (46.6%) participated three or more times. Analysis: Descriptive statistics and multilevel modeling were used in the analysis. Findings: Monthly, 85.7% -100% of nurses reported leaving at least one element of care unfinished. On average, nurses rationed 52.3% -77.7% of the 31 elements of care. Most frequently left unfinished were: documentation of care, emotional support, reviewing interdisciplinary documentation, and changing intravenous catheters (in one unit). Least frequently left unfinished were: the provision of enteral/parenteral nutrition, monitoring patient safety, and important conversations. Only nursing care hours provided by float staff significantly predicted nurse estimates of UNC, Beta = .008, p < .05, R2 = .021. Implications for Military Nursing: UNC increases the risk of patient adverse events; burn patients may be at greater risk due to hospitalization length. Nursing leaders should: work to identify causes of UNC; develop interventions to give bedside nurses more time to complete care.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 02, 2018
- Accession Number
- AD1053542
Entities
People
- Christopher A Vanfosson
Organizations
- University of Texas at Austin