|
| Missed care | Not applicable, N (%) | Not done, N (%) | Done incompletely, N (%) | Don completely, N (%) |
|
| Assessment |
| Patient identification with patient bracelet during shift delivery | | 13 (4.3) | | 288 (95.7) |
| Attention to ventilator settings at the beginning of the shift | 140 (46.5) | 149 (49.5) | | 12 (4.0) |
| Assessment and recording the patient’s mental state (delirium, depression, and anxiety) | 120 (39.9) | 107 (35.5) | 64 (21.3) | 10 (3.3) |
| Control vital signs and record them in time according to the order | 25 (8.3) | 8 (2.7) | 167 (55.5) | 101 (33.6) |
| Report abnormal vital signs immediately after being notified | 282 (93.7) | 9 (3.0) | 6 (2.0) | 4 (1.3) |
| Assessment and evaluation and re-recording if the patient’s condition changes | 292 (97.0) | 7 (2.3) | 1 (0.3) | 1 (0.3) |
| Control and record blood sugar according to the order | 159 (52.8) | 92 (30.6) | 12 (4.0) | 38 (12.6) |
| Taking appropriate treatment in case of abnormal blood sugar within 15 minutes | 300 (99.7) | | | 1 (0.3) |
| Checking the correct location of the endotracheal tube and measuring endotracheal tube cuff pressure at least once per shift | 208 (69.1) | 78 (25.9) | 4 (1.3) | 11 (3.7) |
| Skin and vascular assessment of the upper and lower limbs at the place of restriction | 142 (47.2) | 149 (49.5) | 3 (1.0) | 7 (2.3) |
| Assessment and recording of SPO2 of the patient | 67 (22.3) | 104 (34.6) | 21 (7.0) | 109 (36.2) |
| Treatment for abnormal SPO2 within 5 minutes | 236 (78.4) | 7 (2.3) | 56 (18.6) | 2 (0.7) |
| Assessing the need for suction and performing it on time | 108 (35.9) | 123 (40.9) | 59 (19.6) | 11 (3.7) |
| Recording of endotracheal tube secretion volume and its characteristics | 217 (72.1) | 1 (0.3) | 1 (0.3) | 82 (27.2) |
| Checking and recording the content characteristics of the bag connected to the nasogastric tube | 291 (96.7) | 5 (1.7) | | 5 (1.7) |
| Reporting the abnormal content of nasogastric tube secretions | 293 (97.3) | 6 (2.0) | | 2 (0.7) |
| Measuring the volume and color of urine and recording it | 1 (0.3) | 1 (0.3) | 2 (19) | 280 (93) |
| Reporting the abnormal volume and color of urine | 281 (93.4) | 16 (5.3) | 1 (0.3) | 3 (1.0) |
| Assessing and recording the volume and color of chest tube discharges | 292 (97.0) | 3 (1.0) | | 6 (2.0) |
| Reporting abnormal volume and color of chest tube discharges | 296 (98.3) | | 1 (0.3) | 4 (1.3) |
| Assessing and recording the status of any kind of drain or wound | 290 (96.3) | | 1 (0.3) | 4 (1.3) |
| Reporting the abnormal discharge of any type of drain or wound | 294 (97.7) | 5 (1.7) | 1 (0.3) | 1 (0.3) |
| Mobility and motion |
| Change position every 2 hours | 300 (99.7) | 1 (0.3) | | |
| Moving and walking the patient according to the order | 296 (98.3) | 5 (1.7) | | |
| Applying deep vein thrombosis (DVT) prevention: intermittent bandaging or intermittent pneumatic compression (IPC) | 137 (45.5) | 162 (53.8) | 2 (0.7) | |
| Using proper protection and restraint (bed side rail and bed harness) | 31 (10.3) | 21 (7.0) | 140 (46.5) | 109 (36.2) |
| Response to patient’s needs and device alarm within 5 min |
| Response to the rational request of the patient (defecation, thirst, hunger, movement, etc.) within 5 minutes of the request | 266 (88.4) | 1 (0.3) | 29 (9.6) | 5 (1.7) |
| Responding to device alarms within 1 to 5 minutes of its start | 23 (7.6) | 43 (14.3) | 144 (47.8) | 91 (30.2) |
| Patient education |
| Explaining and educating the conscious patient before performing the procedures | 237 (78.7) | 7 (2.3) | 7 (2.3) | 50 (16.6) |
| Explaining and educating the conscious patient after the procedures | 244 (81.1) | 7 (2.3) | 5 (1.7) | 45 (15.0) |
| Hand hygiene |
| Hand hygiene before touching a patient | | 100 (33.2) | 201 (66.8) | |
| Hand hygiene before performing care procedures | | 103 (34.2) | 198 (65.8) | |
| Hand hygiene after performing care procedures | | 6 (2.0) | 291 (96.7) | 4 (1.3) |
| Hand hygiene after body fluid exposures risk | | 2 (0.7) | 5 (1.7) | 294 (97.7) |
| Hand hygiene after touching a patient | 1 (0.3) | 12 (4.0) | 288 (95.7) | |
| Infection control |
| Eye care according to hospital policy | 253 (84.1) | 35 (11.6) | 11 (3.7) | 2 (0.7) |
| Skin care on ward according to hospital policy | 228 (75.7) | 42 (14.0) | 14 (4.7) | 17 (5.6) |
| Mouthwash based on the needs of the patient in each shift | 241 (80.1) | 34 (11.3) | 13 (4.3) | 13 (4.3) |
| Perineal care: washing the perineum based on the ward’s routine | 253 (84.1) | 18 (6.0) | 13 (4.3) | 17 (5.6) |
| Caring for any type of wound on the body (rinsing the wound if necessary and dressing) | 277 (92.0) | 8 (2.7) | 9 (3.0) | 7 (2.3) |
| Central venous catheter dressing | 281 (93.4) | 5 (1.7) | | 15 (5.0) |
| Replacement of venous line within half an hour of phlebitis | 294 (97.7) | 1 (0.3) | 2 (0.7) | 4 (1.3) |
| Prevention of contact of drains, bags, and connections of the patient with the ground | 22 (7.3) | 1 (0.3) | 1 (0.3) | 277 (92.0) |
| Change the direction of the endotracheal tube to prevent ischemia at least once per shift | 196 (65.1) | 104 (34.6) | | 1 (0.3) |
| Change of disposable devices according to hospital policy (microset, serum, serum set, central venous pressure monitor equipment, infusion syringe, extension tube, Foley catheter, nasogastric tube, feeding set, gavage syringe, closed suction, etc.) | 200 (66.4) | 6 (2.0) | | 95 (31.6) |
| Oxygen therapy |
| Resetting the new ventilator items according to the order within 10 minutes | 301 (100) | | | |
| Appropriately providing oxygenation according to the order | 48 (15.6) | 10 (3.3) | 10 (3.3) | 233 (77.4) |
| Implementation of urgency order |
| Execution of STAT medication orders within 15 minutes after the order | 170 (56.5) | | 5 (1.7) | 126 (41.9) |
| Sending emergency samples within 15 minutes after the order | 170 (56.5) | | 5 (1.7) | 126 (41.9) |
| Nutritional care |
| Feeding the patient within 15 minutes after food distribution | 137 (45.5) | 3 (1.0) | 68 (22.6) | 93 (30.9) |
| Measuring gastric residual volume | 193 (64.1) | 85 (28.2) | 6 (2.0) | 17 (5.6) |
| Adjusting the feed pump | It was not evaluated due to the absence of nutritional bag in the ward during the study |
| Filling the bag connected to the feeding pump within 15 minutes after its completion |
| Observing the semisitting position during feeding | 134 (44.5) | 2 (0.7) | 33 (11.0) | 132 (43.9) |
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