Missed Care in Norwegian Nursing Homes

Missed care is defined as any aspect of required patient care that is omitted (either in part or in whole) or delayed. Discrepancies between availability and/or competence of nursing staff and the patients` care needs might be contributing factors to missed care. This study aims to describe prevalence and types of experienced missed nursing care activities in Norwegian nursing homes experienced by the staff, as well as to explore the relationship between characteristics of nursing staff and missed care. An electronic survey, which included the Norwegian version of the Basel Extent of Rationing of Nursing Care for Nursing Homes (BERNCA-NH), was answered by 715 nursing staff from 46 nursing homes located in different parts of Norway. The results indicate that missed care occurs frequently in Norwegian nursing homes, particularly in care activities involving psychosocial care and documentation, as well as routine care, such as skin care and oral care. Several characteristics of the nursing staff were significantly related to missed care, e.g., gender, occupational group, working time fraction, and years of experience in healthcare work. The statistically largest difference was between occupational groups, where registered nurses reporting average higher levels of missed care compared to staff with less education. An interpretation of the findings is that factors such as nursing staff’s competence, work experience, and continuity of care are crucial to identifying missed care. The results in this study indicate unmet care needs among the nursing home residents, which poses a serious threat to the quality of care and patient safety.