Aim: This study aimed to investigate reasons for unfinished nursing care across the
whole levels of the nursing service as perceived by clinical nurses, ward managers
and executive nurses.
Background: Even though unfinished nursing care has been considered an issue
affected by the system, no studies to date have attempted to investigate reasons
across the whole levels of the nursing service by involving clinical nurses, ward
managers and executive nurses.
Method: A descriptive qualitative approach was performed in 2021 according to the
COnsolidated criteria for REporting Qualitative research guidelines. A large public
health care trust was approached, and a purposeful sample of clinical nurses, ward
managers and executive nurses was invited to attend face-to-face or online interviews. Twenty-nine interviews were performed (19 clinical nurses, 7 ward managers
and 3 executive nurses) and transcribed verbatim. Then, a content analysis was
conducted by considering all narratives together followed by an analytic process to
identify themes and subthemes at the clinical, ward manager and executive levels.
Results: Reasons for unfinished nursing care have emerged at five levels: system
(e.g., poor support towards nursing care), unit (e.g., ineffective models of nursing
care delivery), nurse managers (e.g., inadequate nurse manager leadership),
nurses (e.g., weaknesses in education) and patients (e.g., increased demand for
patients’ care).
Conclusion: The evidence available should be expanded to include also unfinished
nursing care reasons identified at the system and at the ward manager levels, that
both can complete the perceptions of the clinical nurses.
Implications for Nursing Management: The actors composing the nursing service
perceive different reasons and therefore should be involved in detecting and contrasting the unfinished nursing care. The reasons applied or established at the upper
level influence the bedside levels: Therefore, strategies to prevent or minimize the unfinished nursing care should be designed at multi-levels in a system-inclusive
approach.
