Leveraging Interventions to Reduce Missed Nursing Care and Demonstrate Value-based Leadership

• Lauren Alston, Music, University of Delaware

• Rosemary Polomano, Christiana Care, University of Delaware

Missed nursing care (MNC) correlates with longer hospital length of stay (LOS) and higher hospital readmission rates. Reducing LOS and readmission is a strategic priority for ChristianaCare. This study seeks to measure Clinical Nurses’ (CNs) perceptions of MNC and test evidence-based (EB) interventions on LOS, readmissions, and other unit outcomes. Nurse managers (NMs) completed intensive EB training on MNC, LOS, and 30-day readmission. Concurrently, baseline data were collected from CNs using the Revised MISSCARE Survey, with 25 frequency and 22 reason items. To increase recruitment from 17 Newark campus medical-surgical units, the team distributed QR-coded flyers for the REDCap survey. The team regularly rounded to explain the study and provided raffle gifts. Descriptive data are reported on completed surveys using SPSS. Of 95 respondents, most were female (90.5%, n=86), held a Bachelor of Science in Nursing (BSN) (66.3%, n=63), and 52.8% (n=50) had >5 years of experience. Nurses missed 4 of 25 care activities >40% of the time. Meanwhile, 7 activities were rarely missed >60% of the time. Top reasons for MNC were: Inadequate assistive/clerical personnel (75.8%); Inadequate staff (73.7%); Interruptions/multitasking (52.6%); Unexpected rise in patient volume/acuity (45.3%). These findings reveal MNC exists across care categories as nurses prioritize responsibilities. Understanding MNC can help NMs ensure education and resources are available to reduce it. NM training and mentoring continue to support EB interventions to decrease LOS, 30-day readmissions, and improve other unit outcomes.