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Perceptions of Missed Care Across Oncology Nursing Specialty Units

Villamin, Colleen, MSN, RN, OCN, CNL; Anderson, Jacqueline, PhD, RN, NEA-BC, CPHQ; Fellman, Bryan, MS; Urbauer, Diana, MS; Brassil, Kelly, PhD, RN, AOCNS, ACNS-BC, CNL

doi: 10.1097/NCQ.0000000000000324

Background: An opportunity was identified to compare perceptions of the occurrence and types of missed care at a comprehensive cancer center.

Purpose: The purpose was to evaluate the difference in perceived occurrence and types of missed care between medical, surgical, and hematologic oncology units in the context of a newly implemented patient care delivery system, Primary Team Nursing (PTN).

Methods: A descriptive, repeated-measures design was used. The MISSCARE survey was distributed electronically to 580 staff members across 6 inpatient units.

Results: Frequently perceived elements of missed nursing care were ambulation, turning every 2 hours, and care conference attendance. At the time of study implementation, surgical units reported 0.24 higher scores than medical units (P = .017); hematology units reported 0.26 lower scores than surgical units (P = .005). PTN status did not affect MISSCARE scores (P = .525).

Conclusions: Study findings suggest that perceived missed care in a comprehensive cancer center is similar to that in other hospital settings.

University of Texas MD Anderson Cancer Center, Houston.

Correspondence: Colleen Villamin, MSN, RN, OCN, CNL, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030 (

The bio statistical analysis is supported by the National Institutes of Health through MD Anderson's Cancer Center Support Grant P30CA016672.

The authors declare no conflicts of interest.

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Accepted for publication: February 19, 2018

Published ahead of print: April 19, 2018

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