Omissão dos cuidados de enfermagem em unidade de terapia intensiva

Ana Paula Moro Bertoni; Glaucia Fagundes; Bruno de Souza Luchtenberg; Vitoria Rosa Amaral; Josemar Batista

doi:10.36517/2175-6783.20252695197

Authors

Ana Paula Moro Bertoni Centro Universitário Santa Cruz de Curitiba https://orcid.org/0000-0002-7987-1962
Glaucia Fagundes Centro Universitário Santa Cruz de Curitiba https://orcid.org/0009-0007-4573-0057
Bruno de Souza Luchtenberg Centro Universitário Santa Cruz de Curitiba https://orcid.org/0009-0005-9004-2304
Vitoria Rosa Amaral Centro Universitário Santa Cruz de Curitiba https://orcid.org/0009-0000-3547-7667
Josemar Batista Centro Universitário Santa Cruz de Curitiba https://orcid.org/0000-0001-9838-1232

DOI:

https://doi.org/10.36517/2175-6783.20252695197

Keywords:

Nursing Care; Intensive Care Units; Risk Management; Patient Safety; Quality of Health Care.

Abstract

Objective: to examine the prevalence of missed nursing care in an intensive care unit, by professional category and work shift. Methods: this cross-sectional study was conducted in the critical care unit of a teaching hospital. The Missed Nursing Care Survey – Brazil was administered to 38 nursing professionals. Data were analyzed using both descriptive and inferential statistics; p ≤ 0.05 was considered statistically significant. Results: the most frequently missed care activity was patient ambulation three times a day or as prescribed. Labor and material resources were the primary reasons for missed care, with no statistically significant differences between professional categories or work shifts. Participation in interdisciplinary team discussions differed between nurses and nursing technicians (p = 0.027). Lower rates of missed care were observed among daytime staff for four care activities (p ≤ 0.05). Conclusion: a high prevalence of missed nursing care was identified, with differences in the types of care omitted between nurses and nursing technicians, as well as across work shifts. Contributions to practice: these findings support the planning of priority actions to be incorporated into the patient safety plan and highlight the need for further research on the impact of work shift length on missed nursing care.

Downloads

Download data is not yet available.

References

1. Pierre MS, Grawe P, Bergstrom J, Neuhaus C. 20 years after to err is human: a bibliometric analysis of ‘the IOM report’s’ impact on research on patient safety. Saf Sci. 2020;147:105593. doi: https://doi.org/10.1016/j.ssci.2021.105593

2. Rodziewicz TL, Houseman B, Vaqar S, Hipskind JE. Medical error reduction and prevention. StatPearls [Internet]. 2024 [cited Mar 13, 2025]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499956/

3. Leite HDCS, Lopes VCA, Lira JAC, Nogueira LT. Fatores ambientais relacionados à omissão dos cuidados de enfermagem. Ciênc Enferm. 2020;26:20. doi: http://doi.org/10.29393/ce26-13fahv40013

4. Kirwan M, Schubert M. Missed or rationed nursing care: where to now for the nurse manager?. J Nurs Manag. 2020;28(8):1767-69. doi: https://doi.org/10.1111/jonm.13078

5. World Health Organization (WHO). The conceptual framework for the international classification for patient safety [Internet]. 2009 [cited Mar 17, 2025]. Available from: http://www.who.int/publications/i/item/WHO-IER-PSP-2010.2

6. Kalisch BJ, Landstrom GL, Hinshaw AS. Missed nursing care: a concept analysis. J Adv Nurs. 2009; 65(7):1509-17. doi: https://dx.doi.org/10.1111/j.1365-2648.2009.05027.x

7. Saar L, Unbeck M, Bachnick S, Gehri B, Simon M. Exploring omissions in nursing care using retrospective chart review: an observational study. Int J Nurs Stud. 2021;122:104009. doi: https://doi.org/10.1016/j.ijnurstu.2021.104009

8. Gong F, Mei Y, Wu M, Tang C. Global reasons for missed nursing care: a systematic review and meta-analysis. Int Nurs Rev. 2025;72(1):e13096. doi: https://doi.org/10.1111/inr.13096

9. Imam A, Obiesie S, Gathara D, Aluvaala J, Maina M, English M. Missed nursing care in acute care hospital settings in low-income and middle-income countries: a systematic review. Healthc Hum Resour. 2023;21(1):19. doi: https://dx.doi.org/10.1186/s12960-023-00807-7

10. Batista J, Toledo SARG, Santos A, Klasa MGC, Fracasso NV, Heimbecher CT. Clima de seguridad del paciente en Unidades de Cuidados Intensivos en un hospital privado. Rev Cubana Enferm [Internet]. 2022 [cited Mar 17, 2025];38(3):e4777. Available from: https://revenfermeria.sld.cu/index.php/enf/article/view/4777

11. Saldaña DMA, Beltrán LFA, Colmenares SMR, Romero HRA, Cavallo E, Ulloa AC, et al. Professional profile and work conditions of nurses working in intensive care units: a multicentre study. J Clin Nurs. 2022;31(11-12):1697-708. doi: https://doi.org/110.1111/jocn.16026

12. Hang AT, Faria BG, Ribeiro ACR, Valadares GV. Challenges to patient safety in intensive care: a grounded theory. Acta Paul Enferm. 2023; 36:eAPE03221. doi: http://dx.doi.org/10.37689/acta-ape/2023AO03221

13. Jing MJ, Li H, Li CP, Wei XJ, Lin WQ, Zhu SC, et al. The association between working hours with vigilance and executive function of Intensive Care Unit Nurses. J Nurs Manag. 2023;(1):3770404. doi: https://doi.org/10.1155/2023/3770404

14. Bolado GN, Ataro BA, Gadabo CK, Ayana AS, Kebamo TE, Minuta WM. Stress level and associated factors among nurses working in the critical care unit and emergency rooms at comprehensive specialized hospitals in Southern Ethiopia, 2023: explanatory sequential mixed-method study. BMC Nurs. 2024;23(1):341. doi. http://doi.org/10.1186/s12912-024-02004-w

15. Nantsupawat A, Poghosyan L, Wichaikhum OA, Kunaviktikul W, Fang Y, Kueakomoldej S, et al. Nurse staffing, missed care, quality of care and adverse events: a cross-sectional study. J Nurs Manag. 2022;30(2):447-54. doi: http://doi.org/10.1111/jonm.13501

16. Ministério da Saúde (BR). Portaria nº 529, de 1º de abril de 2013. Institui o Programa Nacional de Segurança do Paciente (PNSP) [Internet]. 2013 [cited Mar 13, 2025]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2013/prt0529_01_04_2013.html

17. Siqueira LDC, Caliri MHL, Haas VJ, Kalisch B, Dantas RAS. Validation of the MISSCARE-BRASIL survey - a tool to assess missed nursing care. Rev Latino-am Enfermagem. 2017;25:e2975. doi: https://doi.org/10.1590/1518-8345.2354.2975

18. Silva RPL, Menegueti MG, Siqueira LDC, Araújo TR, Martins MA, Andrade LMS, et al. Omission of nursing care, professional practice environment and workload in intensive care units. J Nurs Manag. 2020;28(8):1986-96. doi: https://dx.doi.org/10.1111/jonm.13005

19. Falk AC, Nymark C, Göransson KE, von Vogelsang AC. Missed nursing care in the critical care unit, before and during the COVID-19 pandemic: a comparative cross-sectional study. Intensive Crit Care Nurs. 2022;72:103276. doi: https://dx.doi.org/10.1016/j.iccn.2022.103276

20. Maran E, Matsuda LM, Magalhães AMM, Marcon SS, Oliveira JLC, Cavalcanti AB, et al. Multiprofessional round with checklist: association with the improvement in patient safety in intensive care. Rev Gaúcha Enferm. 2022;43(spe):e20210348. doi:https://dx.doi.org/10.1590/1983-1447.2022.202100348.en

21. Viana KE, Matsuda LM, Maran E, Reis GAX, Camillo NRS, Pereira ACS, et al. Rounds in intensive care unit: perceptions of a multidisciplinary team. Ciênc Cuid Saúde. 2024;23:e68050. doi: https://doi.org/10.4025/ciencuidsaude.v23i0.68050

22. Milecka D, Homętowska H, Manulik S. The rationing of nursing care phenomenon in the light of scientific reports – definitions, system solutions, assessment methods – PART I. J Educ Health Sport.2023;13(4):281-91. doi: https://doi.org/10.12775/JEHS.2023.13.04.033

23. Min A, Kim YM, Yoon YS, Hong HC, Kang M, Scott LD. Effects of work environments and occupational fatigue on care left undone in rotating shift nurses. J Nurs Scholarsh. 2021;53(1):126-36. doi: https://doi.org/10.1111/jnu.12604

24. Chiappinotto S, Palese A. Unfinished nursing care reasons as perceived by nurses at different levels of nursing services: findings of a qualitative study. J Nurs Manag. 2022;30(7):3393-405. doi: https://doi.org/10.1111/jonm.13800

25. Kalánková D, Bartoníková D, Kolarczyk E, Žiaková K, Młynarska A. Factors contributing to rationed nursing care in the slovak republic—a secondary analysis of quantitative data. Int J Environ Res Public Health. 2022;19(2):702. doi: https://doi.org/10.3390/ijerph19020702

26. Papathanasiou I, Tzenetidis V, Tsaras K, Zyga S, Malliarou M. Missed nursing care; prioritizing the patient’s needs: an umbrella review. Healthcare (Basel). 2024;12(2):224. doi: https://dx.doi.org/10.3390/healthcare12020224

27. Cárdenas WIL, Vidal EG, Ceron RMA, Murillo NAH, Mejía YAS, Jiménez ACJ. Care perceptions in two ICU nursing care delivery models: a qualitative-comparative approach. Invest Educ Enferm. 2022;40(3):e15. doi: https://doi.org/10.17533/udea.iee.v40n3e15

28. Lima MB, Moura ECC, Peres AM, Nascimento LRS, Siqueira RMOT, Costa JP. The nursing team’s perspective on missed nursing care: an analysis of the reasons. Rev Enf Ref. 2022;6(1):e21057. doi: https://doi.org/10.12707/RV21057

29. Kabede C, Geta T, Bikamo E, Nigussie G, Elfios E, Merkine M, et al. Missed nursing care and associated factors among nurses working in public hospitals of Wolaita Zone, 2023: mixed-method study design. Int J Afr Nurs Sci. 2024;20:100748. doi: https://doi.org/10.1016/j.ijans.2024.100748

30. Nazari AM, Borhani F, Zare-Kaseb A, Zafarnia N. The relationship between nurses’ moral competency and missed nursing care: a descriptive-correlational study. BMC Nurs. 2024;23(1):388. doi: https://doi.org/10.1186/s12912-024-02058-w