Institutional members access full text with Ovid®

Share this article on:

A comparison of patient care units with high versus low levels of missed nursing care

Kalisch, Beatrice J.; Gosselin, Kate; Choi, Seung Hee

doi: 10.1097/HMR.0b013e318249727e

Background: In a previous study, the nursing staff on 110 patient care units in 10 hospitals participated in a quantitative study of missed nursing care.

Purpose: The aim of this study was to gain an understanding of the differences in patient care units that had the most missed nursing care with those with the least missed nursing care.

Methodology: Focus groups were conducted with the registered nurse staff on the 5 units with the most missed nursing care and 5 units with the least missed care.

Findings: Ten themes were identified: (a) staffing levels, (b) communication, (c) collective orientation, (d) backup, (e) monitoring, (f) leadership, (g) long tenure, (h) unit size, (i) trust, and (j) accountability. Taken together, the predominant difference found was that units with the least missed care had higher teamwork.

Practice Implications: Strategies for developing interventions to decrease missed care and increase teamwork are presented.

Beatrice J. Kalisch, PhD, RN, FAAN, is Titus Distinguished Professor of Nursing and Director, Nursing Business and Health Systems, School of Nursing, University of Michigan, Ann Arbor. E-mail:

Kate Gosselin, RN, MS, CEN, CPEN, is Clinical Nursing Supervisor, Emergency Department, University of Michigan, Ann Arbor.

Seung Hee Choi, RN, MS, is Research Associate and PhD Student, School of Nursing, University of Michigan, Ann Arbor.

This study was funded by the Blue Cross Blue Shield Foundation of Michigan.

The authors have disclosed that they have no significant relationship with, or financial interest in, any commercial companies pertaining to this article.

© 2012 Lippincott Williams & Wilkins, Inc.