You likely know that the aged care sector in Australia is changing fast. People are living longer, but they are also entering care with more health problems. This change puts a lot of pressure on you and your team. When there is too much work and not enough time, some things do not get done. This is known as missed nursing care.
It is a serious issue that affects the quality of life for residents. It also causes stress for the nurses and carers who want to provide the best support. To fix this, you first need to understand why it happens and how it looks in a real facility.
What is Missed Nursing Care?
In simple terms, missed nursing care is any part of required resident care that is omitted. This could mean the task was delayed, or it was not done at all. It is not usually because staff do not care. Instead, it happens because the demands of the job are higher than the resources available.
Common Tasks That Are Missed
Research shows that some tasks are more likely to be skipped than others. These often include:
- Walking with residents to keep them mobile.
- Providing emotional support or just sitting to talk.
- Cleaning a resident’s teeth or mouth.
- Turning residents in bed to prevent pressure sores.
- Feeding residents who eat slowly.
When you look at this list, you see that many of these tasks are about comfort and long-term health. While a nurse might make sure medicine is given on time, they might not have the ten minutes needed to sit and listen to a resident’s worries.
The Problem of Increased Resident Acuity
One reason you might see more missed nursing care today is increased resident acuity. Acuity refers to how sick a person is and how much help they need. In the past, people moved into residential aged care when they were still somewhat independent. Today, many people stay at home as long as they can. By the time they move into a facility, they often have multiple chronic illnesses.
The Shift in Care Needs
According to data from The Conversation: "Living longer can mean more years with multiple chronic conditions and disabilities." This means:
- Residents need more help with daily tasks like bathing and dressing.
- There are more residents with dementia who need constant supervision.
- Medical treatments are more technical and take more time to perform.
When you have a wing full of residents with high needs, your staff can feel overwhelmed. The "basic" tasks start to fall behind the medical tasks.
Rationing of Nursing Care: A Difficult Choice
When there is not enough time to finish every job, staff must choose what to do first. This is called the rationing of nursing care. It is a mental process where a nurse or carer decides which resident gets help and which resident has to wait.
How Staff Decide
Most staff will prioritize tasks that keep a resident alive or safe. For example:
- Giving life-saving medicine.
- Responding to an emergency fall.
- Wound care for a deep infection.
Tasks that seem less urgent are moved to the bottom of the list. Unfortunately, things like oral hygiene or social interaction stay at the bottom of that list day after day. This rationing can lead to a "conveyor belt" feeling in the facility. As noted in a study on nurse training: "Residents had lost their individual identities and all fun was gone. The nurses and healthcare assistant staff were all so busy and didn’t have much time to interact on personal levels."
Complex Health Care Needs in Modern Facilities
The residents you care for have complex health care needs. This is not just about physical health. It includes mental health, nutrition, and social wellbeing. Dealing with these needs requires a high level of skill and a lot of time.
The Challenge for RNs and Assistants
In many Australian facilities, there is a mix of Registered Nurses (RNs) and Personal Care Assistants (PCAs).
- RNs spend much of their time on paperwork, assessments, and medicine.
- PCAs do most of the hands-on care but may not have the training to spot early signs of sickness.
- The gap between these two groups can lead to communication errors.
If an RN is too busy with paperwork, they cannot supervise the PCAs. This makes it more likely that care will be missed. You must find ways to bridge this gap and make sure everyone has the time they need to do their jobs well.
Findings from the Australian Research
The exploratory study on missed care in Australia highlights several factors that contribute to the problem. It shows that the environment of the facility matters just as much as the number of staff.
Key Factors Identified:
- Staffing Levels: When there are not enough people on a shift, care is always missed.
- Communication: If the team does not talk well, tasks are forgotten.
- Leadership: Facilities with strong managers tend to have less missed care.
- Paperwork: Nurses report that they spend too many hours on computers instead of with residents.
The study suggests that we cannot just hire more people. We also need to change how we work. We need to find ways to reduce the "busy work" so that staff can focus on the residents.
The Impact on Residents and Staff
Missed care has a double impact. It hurts the residents, and it hurts the people looking after them.
For the Residents:
- Health Declines: Missing a walk can lead to a fall later. Missing mouth care can lead to infections.
- Depression: When residents feel like they are on a "conveyor belt," they become lonely and sad.
- Loss of Dignity: If a resident is not cleaned properly or has to wait a long time for help, they lose their sense of self-worth.
For the Staff:
- Moral Distress: Most nurses enter the field to help people. When they cannot provide good care, they feel guilty and sad.
- Burnout: Constant pressure leads to staff leaving the industry.
- Low Morale: A team that feels it is failing will not work well together.
Using Technology to Support Care Teams
You can see that time is the biggest enemy in residential aged care. One way to win back time is through smart technology. Governa AI is built to help you manage the data and paperwork that takes up so much of your day.
How AI Can Help
By using Ai in Aged Care, you can:
- Automate the tracking of care tasks so nothing is forgotten.
- Make documentation faster and easier for your nurses.
- Identify residents who might be at risk of missed care before it happens.
- Support your team with better data for decision-making.
When you reduce the time your RNs spend in front of a screen, you give them back to the residents. This helps reduce the rationing of nursing care and improves the overall atmosphere of your facility.
Frequently Asked Questions
Why is missed care increasing in Australia?
It is increasing because of increased resident acuity. People in care are sicker than they used to be, but staffing levels have not always kept up with these complex health care needs.
What are the most common types of missed care?
The most common types are social and emotional support, walking (ambulation), and oral hygiene. These are often seen as "extra" rather than "essential" when staff are busy.
Can technology really reduce missed nursing care?
Yes. Technology can handle time-consuming tasks like scheduling and report writing. This allows staff to spend more time on direct resident care.
How does Governa AI help facility managers?
Governa AI provides a clear view of what is happening in your facility. It helps you see where care might be falling behind so you can act quickly to fix it.
Improving Your Missed Nursing Care Plan
You have the power to change how care is delivered in your facility. It starts by admitting that missed nursing care is a real risk. You must look at your current processes and ask where the time is going. Are your nurses spending too much time on paperwork? Are your residents' complex health care needs being met with enough staff?
By using modern tools and focusing on the human side of care, you can move away from the "conveyor belt" model. You can build a place where residents feel seen and heard. You can support your staff so they feel proud of the work they do every day.
The goal is simple: to make sure every resident gets the care they deserve, every single time. With the right strategy and the right technology, you can make this a reality for your facility.
Reference: https://www.sciencedirect.com/science/article/abs/pii/S1322769616300786
