Unfinished nursing care occurrence, priority order and reasons as perceived by nursing students: An international study.

Aim: The study aimed to measure and compare differences (a) in the unfinished nursing care interventions overall and the order in which they are left unfinished; and (b) in the underline reasons, as perceived by Italian, Slovak and Turkish nursing students.

Background: In recent years, in the nursing education context a novel line of research in the field of unfinished nursing care as those interventions required by patients, but omitted or delayed, has emerged. However, no studies have been conducted at the international level.

Design: An international, comparative cross-sectional study was performed in 2022-2023 and reported here according to Strengthening the Reporting of Observational Studies in Epidemiology guidelines.

Methods: A multinational research network was formed with a convenient sample of 13 universities and 60 campuses (4595 students). The Unfinished Nursing Care Survey for Students (UNCS4S) was administered. A total of 1850 students participated.

Results: According to the UNCS4S total score, Italians reported an average 50.9 out of 110 unfinished nursing care interventions (CI95 % 47.6-54.1), Slovakians 54.9 (CI95 % 53.7-56.1) and Turkish students 50.4 (CI95 % 49.2-51.5) (p<0.001). Some interventions were reported more often as unfinished across countries as supervising the task assigned to the nursing aides, going to the patient without being called, spending the required time with the patient and their caregivers and emotionally supporting patients and their caregivers. In terms of reasons, total scores were statistically different across countries (Italy: 45.92 out of 90, CI95 % 43.91-47.9; Slovakia: 62, CI95 % 61.02-62.98; Türkiye: 72.29, CI95 % 71.13-73.45; p<0.001); however, at the factor level, communication issues, lack of material resources and issues in supervision of nursing aides were reported in all countries as the most important reasons of the unfinished nursing care.

Conclusions: Students learn to shape and set priorities early in their nursing careers with similar order in what to leave unfinished as first, despite the different educational structures, care cultures and healthcare systems. Among the unfinished nursing care reasons perceived, the most influential were similar across countries, suggesting common areas for improvement. How to better prepare students to be resilient and capable of managing the challenges posed by unfinished nursing care episodes due to the lack of resources and communications issues should be considered as a priority by nurse educators.