不同错过护理活动与患者预后之间的关系：一项系统综述

IF 7.1 1区医学 Q1 NURSING

International Journal of Nursing Studies Pub Date : 2025-08-07 DOI:10.1016/j.ijnurstu.2025.105183

Wenqi He , Hua Yuan , Wei Luo , Meixue Hou , Meiyan Liu , Hui Xue , Xiuying Zhang

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引用次数: 0

摘要

遗漏护理是护理质量的一个关键指标，与患者的负面结果有关。然而，错过护理的比率因不同的护理活动而异。将错过的护理作为一种综合指标可能缺乏与患者预后相关的特异性。目的探讨不同错过护理活动与患者预后的关系。方法系统检索PubMed、Scopus、Web of Science和CINAHL数据库，检索截止到2024年11月已发表的相关研究。研究遗漏护理活动与患者预后之间的关系。使用NICE公共卫生评价指南评估偏倚风险，报告本评价时遵循PRISMA指南。审查方案已在PROSPERO注册（CRD42024618442）。结果经筛选，共纳入17篇文献。大多数研究是横断面的，依靠护士或患者的自我报告来评估错过的护理。本综述发现，不同类型的错过护理活动与不同的患者预后相关。主要发现如下：1)错过临床护理活动与患者安全结果密切相关。具体而言，患者监测、基本护理、治疗和症状管理方面的疏漏与跌倒、再入院、死亡率、尿路感染和血流感染等不良事件显著相关；2)缺乏沟通和基本护理与患者满意度降低密切相关；3)此外，特定的患者结果，如实现完全口服喂养的时间和住院时间，也与错过的临床护理活动有关。尽管高质量的证据仍然有限，但很明显，不同的错过护理活动与不同的患者结果有关，这表明它们对患者结果的影响因活动而异。未来的研究应侧重于制定有针对性的干预策略，以减少与患者预后密切相关的错过护理活动。

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The relationship between different missed care activities and patient outcomes: A systematic review

Background

Missed care is a key indicator of nursing quality and has been linked to negative patient outcomes. However, the rates of missed care vary across different nursing activities. Treating missed care as a composite indicator may lack specificity in relation to patient outcomes.

Objective

This review aims to explore the relationship between different missed care activities and patient outcomes.

Methods

We systematically searched PubMed, Scopus, Web of Science, and CINAHL databases for relevant studies published up to November 2024. Studies examining the relationship between missed care activities and patient outcomes were included. The risk of bias was evaluated using the NICE public health review guidelines, and the PRISMA guidelines were followed in reporting this review. The review protocol was registered on PROSPERO (CRD42024618442).

Results

After screening, 17 articles were included. Most studies were cross-sectional, relying on nurse or patient self-reporting to assess missed care. This review found that different types of missed care activities were related to various patient outcomes. The main findings were as follows: 1) missed clinical care activities were closely linked to patient safety outcomes. Specifically, omissions in patient monitoring, basic care, treatment and symptom management were significantly associated with adverse events such as falls, readmissions, mortality, urinary tract infections, and bloodstream infections; 2) missed communication and basic care were strongly associated with reduced patient satisfaction; 3) additionally, specific patient outcomes, such as time to achieve full oral feeding and length of hospital stay, were also associated with missed clinical care activities.

Conclusion

Although high-quality evidence remains limited, it is clear that different missed care activities are linked to varying patient outcomes, suggesting that their effects on the patient outcomes differ across activities. Future research should focus on developing targeted intervention strategies to reduce missed care activities that are closely linked to patient outcomes.

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来源期刊

International Journal of Nursing Studies 医学-护理

CiteScore

15.00

自引率

2.50%

发文量

181

审稿时长

21 days

期刊介绍： The International Journal of Nursing Studies (IJNS) is a highly respected journal that has been publishing original peer-reviewed articles since 1963. It provides a forum for original research and scholarship about health care delivery, organisation, management, workforce, policy, and research methods relevant to nursing, midwifery, and other health related professions. The journal aims to support evidence informed policy and practice by publishing research, systematic and other scholarly reviews, critical discussion, and commentary of the highest standard. The IJNS is indexed in major databases including PubMed, Medline, Thomson Reuters - Science Citation Index, Scopus, Thomson Reuters - Social Science Citation Index, CINAHL, and the BNI (British Nursing Index).