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Missed Care and Nurse-Sensitive Indicators


Missed care is “nursing care that is delayed, partially completed, or not completed at all” (Patient Safety Primer, 2016, par. 2). It is a problem that is usually faced by professionals because they need to interact with a great number of people who are supposed to remember about all interventions prescribed by other health care staff and maintain them every day. Missed care deals with the lack of labor and material resources, as well as teamwork and communication. If at least one of them is omitted, nursing care is likely to be also missed. While working under the pressure of limited time and competition, in unsafety environments or with a poor supply chain, nurses have more chances to face missed care.

Nurse-Sensitive Indicators

Nursing-sensitive indicators (NSIs) are those indicators that provide healthcare professionals with the opportunity to claim whether the care was provided decently or not. They focus on the structure, process, and outcomes of the procedures maintained by the professional, considering the quality of services as well as patient and nurse satisfaction. In general, NSIs allow nurses to consider what difference was achieved due to their actions. In addition to that, the indicators can include the number of hours nurses spend with patients, the number of patient falls, the level of satisfaction, etc.

Improved Practice and Associated Health Outcomes

In order to improve health outcomes for patients and reduce missed care, nurses can utilize various approaches. Integrating needs theory, for example, nurses would educate their patients on how to remain independent so that they can prevent missed care knowing what should be done. The evidence from research studies and systematic reviews can be used to consider what problems are more likely to occur or to measure missed care. Clinical judgment determines diagnosis and treatment interventions that are defined by the healthcare professional. Being a personal judgment, it can be biased and inaccurate, but when involving the team of several professionals, the outcomes tend to be improved greatly (Kienle & Kiene, 2011). Information obtained from research should be systematized by the leader and applied by the team of professionals for them to follow one guideline according to new models of medical professionalism, for example. Integrating interprofessional perspectives, professionals can improve the quality of care, providing both physical and psychological support.

Missed Care and Quality Improvement

Missed care reveals the poor quality of healthcare services. It shows that some problems are still observed and require more attention. Still, its detailed consideration allows for finding out what or who causes missed care and improving the situation. Continuous assessment of quality gives an opportunity to assess the case before and after the intervention and to observe the changes.

Executive Brief

Missed care is a critical issue for nurses because they are those professionals who are patients’ advocates. The problem usually occurs because of the lack of personnel, inappropriate work environment, or poor teamwork. To improve this situation, nurses should define their main problems. Then they can use information from the research studies and theoretical literature to define what really works in practice and follow such plan of action. The intervention should be maintained with other professionals to omit misunderstandings and reach a common goal.

Relation to AACN Masters Essentials III Quality Improvement and Safety

Safe and effective delivery of care is critical for the achievement of positive health outcomes. It can be achieved, omitting missed care if considering AACN Masters Essentials. Much attention is to be put on quality improvement and promotion of such important things like safety, time, and efficiency, etc., which is critical in practice, as an absence of problems with them reduces the chances of experiencing missed care (AACN, 2011).


AACN. (2011). The essentials of master’s education in nursing. Web.

Kienle, G., & Kiene, H. (2011). Clinical judgment and the medical profession. Journal of Evaluation in Clinical Practice, 17(4), 621-627.

Patient Safety Primer. (2016). Web.

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