The psychometric properties of the MISSCARE nursing tool

Since 2006, US nurse Beatrice Kalisch has explored the relationships among the work environment, patient care demands and staffing issues on nursing outcomes (Kalisch 2006). Subsequently, the MISSCARE (Kalisch and Williams 2009) tool was developed to quantify what types and how frequently nursing care was missed and why omissions occurred. The MISSCARE survey has become one measure in the transactions of nursing, which refers to any aspect of care that is entirely or partially omitted or deferred. The tool comprises two portions: the elements of missed nursing care, containing 24 items where nurse participants are asked to rate how often each care aspect was missed with the options ranging from “rarely,” “occasionally,” “frequently,” and “always” missed. The second component explores the reasons for missed nursing care, with 17 varied reasons for why nursing care was missed within their work area. The scale used offered four options indicating degrees of intensity for why care was missed: if it was a “significant reason,” “moderate reason,” “minor reason,” or “not a reason” for missed care.