A new study shows New Zealand nurses are concerned about missed patient care.

The Eastern Institute of Technology survey of nurses working in hospitals, aged care and the nation’s primary health care sector found nurses hold concerns about missed care, which is often the result of nurses’ skill mix, ineffective methods for determining staffing levels and competing demands that reduce care time with patients.

The After Hours Nurse Staffing, Work Intensity, and Quality of Care study, led by Dr Clare Harvey, discovered missed nursing care is more likely to occur across all shifts, and not just night shifts when staffing levels are reduced.

The survey of mostly female nurses aged 45 years or over, in line with statistics that show the average age of nurses in New Zealand is 46 years, found a link between nurses who work despite feeling unwell, stressed or fatigued and a higher rate of missed nursing care.

“Nearly 50 per cent of respondents feel obligated to colleagues to work despite feeling unwell, and qualitative data also reveals a nursing workforce whose inadequate sick leave entitlements means they have to work,” the Institute states.

“The researchers say much of nurses’ care work has become invisible in the face of escalating costs and that an international approach is needed to achieve a balance in care that is truly patient-centred, appropriately managed and cost effective.”

The results come after the New Zealand Nursing Organisation (NZNO) blamed care rationing in the under-resourced health sector for an increase in the number of serious adverse events (SAEs) reported by District Health Boards (DHBs) in 2013-14.

The Health Quality and Safety Commission’s 2013-14 report shows the number of serious adverse events increased four per cent from 2012-13, from 437 up to 454.

The Commission attributed the slight increase in SAEs to the health sector’s commitment to improve its reporting of cases.

NZNO professional nursing adviser Kate Weston said the number of serious adverse events has more than doubled since the first report in 2007.

“There is increasing confidence in the reporting system however we are not convinced that the increase in reported events over the last seven years can be solely attributed to better reporting,” she said.

“The research demonstrates that there are some patient indicators that are particularly sensitive to nursing numbers and skill mix - these include patient falls, infections and pressure areas.

“There is an urgent need to address nursing resourcing in hospitals and communities to reduce these adverse events.”

Ms Weston said nurses are not blasé about falls and other serious harmful events.

“These accidents are the result of care rationing and sadly it happens every day - the number of nursing hours is just insufficient to meet nursing needs of patients, both in hospitals and in the community,” she said.

“The decision as to what care to prioritise or leave out because of insufficient resourcing is an all too frequent moral dilemma for nurses.

“The report is silent on this issue and we hope the HQSC undertakes further analysis of why and how these serious events happen.”