Development and psychometric testing of a tool to measure missed nursing care

• Published in: The Journal of nursing administration Vol. 39; no. 5; p. 211
• Main Authors: Kalisch, Beatrice J, Williams, Reg Arthur
• Format: Journal Article
• Language: English
• Published: United States 01.05.2009
• Subjects: Data Collection - methods; Factor Analysis, Statistical; Focus Groups; Humans; Medical Errors - nursing; Medical Errors - statistics & numerical data; Midwestern United States; Nursing Administration Research - methods; Nursing Care - statistics & numerical data; Nursing Evaluation Research - methods; Nursing Methodology Research; Nursing Staff, Hospital - organization & administration; Nursing Staff, Hospital - psychology; Personnel Staffing and Scheduling - organization & administration; Psychometrics; Qualitative Research; Quality of Health Care - statistics & numerical data; Time and Motion Studies; Workload - statistics & numerical data; Midwestern United States
• ISSN: 1539-0721
• DOI: 10.1097/NNA.0b013e3181a23cf5

In a qualitative study, medical-surgical and intensive care staff nurses reported that they did not complete a significant amount of nursing care on regular basis. Thus, it was determined that a quantitative tool was needed to measure the amount and type of missed nursing care and the reasons for missing care. The authors report the results of a psychometric evaluation of this tool (The Missed Nursing Care Survey [MISSCARE Survey]) to measure missed nursing care (part A) and the reasons for missed nursing care (part B). Two studies were conducted--study 1 (n = 459) and study 2 (n = 639). A sample of staff nurses was drawn from 35 medical-surgical, rehabilitation, and intensive care patient units in 4 acute care hospitals. Acceptability was high, with 85% of the respondents answering all items on the survey. Factor analysis with Varimax rotation resulted in a 3-factor solution for part 2 (communication, labor resources, and material resources). Cronbach alpha values ranged from 0.64 to 0.86. Confirmatory factor analysis demonstrated a good fit of the data. Using a contrasting group approach, a comparison of nurse's perceptions of missed care on intensive care units versus rehabilitation units resulted, as hypothesized, in a significantly lower amount of missed care on intensive care units. Pearson correlation coefficient on a test-retest of the same subjects yielded a value of 0.87 on part A and 0.86 on part B. Although further validation of the MISSCARE Survey is needed, current evidence demonstrates that the tool meets stringent psychometric standards.