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Unraveling Care Omissions

Bittner, Nancy Phoenix PhD, RN, CCRN; Gravlin, Gayle EdD, RN, NEA-BC; Hansten, Ruth PhD, RN, FACHE; Kalisch, Beatrice J. PhD, RN, FAAN

Journal of Nursing Administration:
doi: 10.1097/NNA.0b013e3182378b65
Departments: Focus on Quality

Evidence points to the omission of required nursing care as a pervasive problem in acute care hospitals. Labor and material resource constraints, increasing patient complexity, ineffective delegation, and poor communication have been identified as contributing factors. Nurse executives should examine the degree and causes of missed care in their organizations. Action plans should be developed based on identification of issues contributing to this serious concern, thus promoting safe patient care.

Author Information

Author Affiliations: Associate Dean and Professor, School of Nursing, Science and Health Professions, Regis College, Weston, Massachusetts (Dr Bittner); Associate Chief Nurse, Nursing Education, Research & Professional Development, Lahey Clinic, Burlington, Massachusetts (Dr Gravlin); Principal, Hansten Healthcare PLLC, Port Ludlow, Washington (Dr Hansten); Chair, Nursing Business and Health Systems and Titus Professor, School of Nursing, University of Michigan, Ann Arbor (Dr Kalisch).

The authors declare no conflict of interest.

Correspondence: Dr Bittner, Regis College, 235 Wellesley St, Weston, MA 02493 (

© 2011 Lippincott Williams & Wilkins, Inc.