[Decision Making process and missed nursing care: findings from a scoping review]. 2020

Luisa Sist, and Alvisa Palese

. Decision Making process and missed nursing care: findings from a scoping review. BACKGROUND Several aspects of the Missed Care (MNC) model have been studied (conceptual aspects, causes, process, measurement instruments, outcomes) however, the decision-making processes influencing the MNC have not yet been settled into an accessible guide. OBJECTIVE To describe (a) the terms most used in the literature to define the decision-making processes influencing the MNC, (b) the conceptual models, as well as (c) the available tools. METHODS A scoping review was carried out in March-August 2020 by consulting the following databases: Cochrane Library, Pubmed, Scopus, CINAHL Complete, PsycINFO. Of the 385 retrieved studies, 92 abstracts were evaluated and 36 studies included. RESULTS Four terms are used to address the process of nursing intervention delivered on time, postponed or missed: (a) Priority setting; (b) Prioritisation of clinical care; (c) Implicit rationing; and (d) Time scarcity. While the lack of time expresses the common denominator, a substantial difference emerges between priority setting and rationing: the first establishes a preferential sequence of activities with the result of delaying those less significant; the second leads to unfinished nursing care. Decision models to date have not considered the processes influencing MNC; therefore, the available measurement instruments are also of little use. CONCLUSIONS The decision-making processes underlying MNC have not yet been well understood, and described using different terms. Reliable instruments to measure them are still lacking.

UI MeSH Term Description Entries
D009732 Nursing Care Care given to patients by nursing service personnel. Care, Nursing,Management, Nursing Care,Nursing Care Management
D003657 Decision Making The process of making a selective intellectual judgment when presented with several complex alternatives consisting of several variables, and usually defining a course of action or an idea. Credit Assignment,Assignment, Credit,Assignments, Credit,Credit Assignments
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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