Below sits a complete NUR 300 Module 7 final project paper on missed nursing care, laid out as an APA 7 student paper: title page, six headed sections, conclusion, margin notes and verified references. Searches like "nur 300 module 7 assignment", "nur300 module 7 final project" and "nur 300 module 7 example" land here.
The NUR 300 Module 7 example, in full
Care Left Undone: Missed Nursing Care on a Medical-Surgical Unit and a Teamwork-Based Response
[Student Name]
Southern New Hampshire University
NUR 300: Scholarly Inquiry
Final Project
[Instructor Name]
[Date]
The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.
Care Left Undone: Missed Nursing Care on a Medical-Surgical Unit and a Teamwork-Based Response
Every nurse knows the list of things that did not get done by the end of a busy shift: the patient who was not walked, the teaching that was postponed, the turn that came an hour late, the conversation with a frightened family that never happened. Nursing research calls this missed nursing care, and it has become one of the most studied problems in hospital nursing because it sits between staffing and patient outcomes. This paper examines missed nursing care on a composite 34-bed medical-surgical unit, reviews what the research shows about its extent, causes and consequences, and recommends a teamwork-based response with a plan for measuring whether it works. The argument is that missed care is not simply a sign of too few nurses, but a product of how a team shares work, and that a unit can reduce it even before staffing improves.
The Practice Issue
In the research literature, care counts as missed when something a patient needed was skipped entirely, done only partly, or put off long enough to matter (Kalisch et al., 2009). It is an error of omission rather than commission, which makes it harder to see. A wrong medication produces an incident report, but a skipped ambulation produces nothing at all until the patient becomes weaker, develops a pressure injury, or falls days later.
On the composite medical-surgical unit, the problem became visible when the unit's nurses and nursing assistants completed the MISSCARE Survey, a validated instrument that asks staff how often specific care activities are missed and why (Kalisch & Williams, 2009). Of the 61 staff invited, 47 responded. More than half reported that ambulation three times a day or as ordered was frequently or always missed, and more than a third reported the same for mouth care and for patient teaching. The reasons cited most often were an unexpected rise in patient volume or acuity, inadequate assistive personnel, and, notably, other staff who did not help or did not communicate when care was not done. Those findings shaped both the literature review and the recommendation that follow.
Review of the Literature
The research on missed care can be read as answers to three questions. The first is how common missed care is. In a survey of nearly 3,000 registered nurses in 46 acute hospitals in England, 86 percent reported that at least one necessary care activity had been left undone on their most recent shift, most often comforting and talking with patients, educating patients, and updating care plans (Ball et al., 2014). Studies in the United States have found similar patterns, with ambulation, turning, mouth care, teaching and emotional support among the most frequently missed elements (Kalisch et al., 2009). Missed care is therefore the normal condition of many hospital shifts rather than an occasional failure.
The second question is why it happens. Staffing clearly matters. Units with more nursing hours per patient day report less missed care (Kalisch et al., 2011), and nurses caring for more patients per shift are more likely to leave care undone (Ball et al., 2014). Yet staffing does not explain everything. Studies using the MISSCARE Survey have found that teamwork is independently associated with missed care: on units where staff rated teamwork higher, less care was missed, even after staffing levels were taken into account (Kalisch & Lee, 2010). Staff consistently describe communication breakdowns, unclear delegation and reluctance to ask for or offer help as reasons care is missed.
The third question is what missed care costs patients. A review of studies examining care left undone and patient outcomes found associations with medication errors, infections, pressure injuries, lower patient satisfaction and, in some studies, readmission and mortality (Recio-Saucedo et al., 2018). The authors cautioned that most of the studies were cross-sectional and relied on nurse reports, so they establish association rather than cause. Even with that caution, the literature places missed care on the path between the conditions of nursing work and the outcomes patients experience, which is why it matters to the profession.
Recommended Response
Because the unit cannot add nurses in the short term, and because the evidence shows that teamwork affects missed care independently of staffing, the recommended response is a structured teamwork intervention for all nursing staff on the unit, combined with two changes to daily work. The intervention is modeled on a train-the-trainer program that taught teams to monitor each other's workload, offer and request help, and communicate about care that could not be completed. When tested on acute care units, it improved staff ratings of teamwork and reduced missed nursing care (Kalisch et al., 2013).
The two supporting changes address the reasons reported on the unit's own survey. First, a midshift check-in of no more than five minutes, in which each nurse and nursing assistant names any care at risk of being missed so that the team can redistribute it. Second, ambulation and mouth care, the two most frequently missed activities, will be assigned by name to a specific staff member for every patient when assignments are made at 7:00 a.m., rather than left as a shared responsibility that no one owns. Each part of the response targets a cause documented in the unit data, and none depends on a staffing increase to begin.
Implementation and Evaluation
Implementation would take six months. In the first month, the nurse manager and two staff nurses would complete trainer preparation and schedule sessions. In months two and three, every nurse and nursing assistant would attend a four-hour teamwork session on paid time, taught by the unit trainers, and the midshift check-in and named assignment of ambulation and mouth care would begin at the end of month two. Months four through six would be used to reinforce the new practices through brief coaching at huddles.
Evaluation would repeat the MISSCARE Survey at month six, with the goal of reducing the share of staff reporting that ambulation is frequently or always missed from more than half to under one third, and a similar reduction for mouth care and teaching. The unit would also track two outcomes linked to missed care in the literature, the rate of falls and the rate of new pressure injuries, each counted per 1,000 patient-days, while recognizing that six months may be too short to show a reliable change in rare events. A short teamwork measure would be collected before and after training to see whether any reduction in missed care follows a change in how staff work together.
Implications for Professional Practice
Missed care is sometimes treated as an unfortunate by-product of workload that individual nurses can do nothing about. The evidence suggests otherwise. Nurses decide, many times a shift, what can wait and what cannot, and those decisions are shaped by whether colleagues will help and whether anyone will notice what was left undone. Making missed care visible, discussing it openly and sharing the work are professional responsibilities, not only management tasks. At the same time, a teamwork intervention should not be used to excuse unsafe staffing. If missed care remains high after teamwork improves, the data gathered through this project become evidence that nurse leaders can bring to staffing decisions.
Conclusion
Missed nursing care is common, it is linked with harm to patients, and it grows out of both staffing and the way nursing teams work. On the composite medical-surgical unit examined here, staff identified ambulation, mouth care and teaching as the care most often missed, and named poor teamwork among the causes. A structured teamwork intervention, a brief midshift check-in and named responsibility for the most frequently missed care offer a practical response that the unit can begin at once and measure with the same survey that revealed the problem. Addressing care left undone is part of what it means to practice nursing as a profession.
References
Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2014). 'Care left undone' during nursing shifts: Associations with workload and perceived quality of care. BMJ Quality & Safety, 23(2), 116-125. https://doi.org/10.1136/bmjqs-2012-001767
Kalisch, B. J., Landstrom, G. L., & Hinshaw, A. S. (2009). Missed nursing care: A concept analysis. Journal of Advanced Nursing, 65(7), 1509-1517. https://doi.org/10.1111/j.1365-2648.2009.05027.x
Kalisch, B. J., & Lee, K. H. (2010). The impact of teamwork on missed nursing care. Nursing Outlook, 58(5), 233-241. https://doi.org/10.1016/j.outlook.2010.06.004
Kalisch, B. J., Tschannen, D., & Lee, K. H. (2011). Do staffing levels predict missed nursing care? International Journal for Quality in Health Care, 23(3), 302-308. https://doi.org/10.1093/intqhc/mzr009
Kalisch, B. J., & Williams, R. A. (2009). Development and psychometric testing of a tool to measure missed nursing care. Journal of Nursing Administration, 39(5), 211-219. https://doi.org/10.1097/NNA.0b013e3181a23cf5
Kalisch, B. J., Xie, B., & Ronis, D. L. (2013). Train-the-trainer intervention to increase nursing teamwork and decrease missed nursing care in acute care patient units. Nursing Research, 62(6), 405-413. https://doi.org/10.1097/NNR.0b013e3182a7a15d
Recio-Saucedo, A., Dall'Ora, C., Maruotti, A., Ball, J., Briggs, J., Meredith, P., Redfern, O. C., Kovacs, C., Prytherch, D., Smith, G. B., & Griffiths, P. (2018). What impact does nursing care left undone have on patient outcomes? Review of the literature. Journal of Clinical Nursing, 27(11-12), 2248-2259. https://doi.org/10.1111/jocn.14058
How this NUR 300 Module 7 example is structured
The final paper has to read as one document, so the structure follows the argument rather than the order in which the milestones were written. The introduction states the thesis and previews the path. The practice issue section defines missed care and shows it on one unit with survey figures. The literature review is organized by three questions: how common missed care is, why it happens, and what it costs patients. The recommendation grows directly out of the causes identified in the review, and the implementation and evaluation section gives it owners, a timeline and a measure. A closing section on professional practice explains why missed care is an ethical matter for nursing, not only a staffing statistic.
Get NUR 300 Module 7 written to your instructions
Send the final project guidelines and rubric with all three of your milestones and the instructor feedback on each. The desk assembles and revises a sample final paper to that brief in 24 to 48 hours, and your first sample is free. The paper above is an original model document written by our desk, not a submitted student paper and not an official Southern New Hampshire University document.
NUR 300 Module 7 questions, answered
What does the NUR 300 Module 7 final project usually involve?
In most sections the final project brings the earlier milestones together into one scholarly paper on a professional nursing practice issue: the issue itself, a review of the literature, and a recommended response. Instructors expect the milestone feedback to be addressed, the sections to connect, and the APA formatting to be clean throughout.
Can I paste my three milestones together to make the NUR 300 final paper?
Pasting them together usually produces repeated introductions, shifting arguments and sources that appear once and vanish. Start from one thesis, rewrite the transitions so each section leads into the next, remove repetition, and fold in the instructor's comments. The final paper should read as if it had been planned as a whole.
How long should the NUR 300 final paper be?
Length is set by your guidelines and rubric, and sections differ. Many final papers in this course run somewhere between five and ten pages of body text plus a title page and references. Spend the most words on the parts the rubric weights most heavily, which are often the literature and the recommendation.