背景:未完成的护理在全球医疗保健环境中越来越受到关注。鉴于他们的负面结果,持续评估那些通常被推迟或错过的护理干预措施至关重要,以及根本原因和后果。COVID-19在全球范围内的大流行使医疗机构难以维持其护理的可持续性和连续性,这也影响了未完成的护理现象。然而,到目前为止,尚未对COVID-19大流行期间进行的研究进行总结。这项研究的主要目的是系统地回顾这种情况的发生,原因,以及COVID-19大流行期间医疗机构患者护理未完成的后果。
方法:在PROSPERO(CRD42023422871)中注册的系统评价。使用了系统审查和荟萃分析声明指南的首选报告项目以及用于横断面研究的JoannaBriggs研究所关键评估工具。MEDLINE-PubMed,护理和相关健康文献的累积指数,和Scopus从2020年3月到2023年5月进行了搜索,使用在该领域建立的关键字作为错过的护理,未完成的护理,或隐含的配给。
结果:纳入了主要在欧洲和亚洲国家进行的25项研究,并被评估为具有良好的方法学质量。使用了以下工具:MISSCARE调查(=14);巴塞尔护理配给范围(=1),也以其修订形式(=2)和关于疗养院(=2);感知内隐护理配给(=4);重症监护病房遗漏护理(=1);和未完成护理调查(=1)。在一些国家的研究中出现的未完成的护理干预措施的顺序与大流行前的数据基本一致(例如,口腔护理,步行)。然而,国家和国家间出现了一些有趣的变化。相反,在大流行期间,与护士的情绪状态和幸福感接近的劳动力资源和原因被一致提到对未完成的护理影响最大。没有一项研究调查了未完成的护理的后果。
结论:在大流行期间,有两大洲领导了该领域的研究:欧洲,这项研究已经很成熟,亚洲,这项研究是新的。虽然未完成的护理发生似乎是基于整个欧洲预先建立的模式(例如,关于基本面需求),亚洲国家出现了新的模式。其中的原因,研究结果的同质性与大流行前记录的结果一致.
BACKGROUND: Unfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying
reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically
review the occurrence of,
reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic.
METHODS: Systematic
review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing.
RESULTS: Twenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and
reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care.
CONCLUSIONS: Two continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the
reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.