Unfinished Nursing Care Survey for Students (UNCS4S) : A multicentric validation study

Background: Unfinished Nursing Care (UNC) indicates required interventions that are delayed or omitted. Nursing students are also exposed to UNC during their clinical rotations. However, no tools have been validated to date to collect UNC as perceived by them. Objectives: To validate a tool measuring UNC as perceived by nursing students. Design: A validation study in 2018 by following the COnsensus-based Standards for the selection of health Measurement INstruments guideline. Setting: Three nursing programmes in Northern Italy. Participants: All 1190 students who were attending their clinical rotation in hospital or community settings, were eligible. To assess the criterion validity, 30 clinical nurse supervisors in a random sample of units were involved. Methods: Content and face validity of the Unfinished Nursing Care Survey tool (UNCS) were assessed; then the tool, divided into part A (unfinished interventions) and B (reasons) was administered via Google and paper-pencil. Acceptability, construct validity (Mokken Scale Analysis, Exploratory and Confirmatory Factor Analyses), hypothesis testing, and criterion validity were assessed. Results: 737 students (61.9%) and 30 (100%) clinical nurse supervisors participated. On the Mokken Scale, with regard to part A, nursing interventions were ordered in higher and lower priority, reflecting different degrees of difficulty in terms of leaving the interventions unfinished. In the Confirmatory Factor Analyses, reasons for UNC were categorised into ‘Communication’, ‘Priority setting’, ‘Nurses' aides' supervision’, ‘Material resources’, ‘Human resources’, and ‘Workload unpredictability’. Students in the second year perceived higher UNC occurrence; only some individual and nursing programme variables were significantly correlated with the UNC. No statistical differences emerged between the UNC perceptions of students and that of their clinical supervisors. Conclusion: The Unfinished Nursing Care Survey for Students is composed of part A (22 items) and part B (18 items) seems to be valid in terms of acceptability, construct validity, hypothesis testing, and criterion validity.