Linking nurse practice environment, safety climate and job dimensions to missed nursing care
Leodoro J. Labrague
Abstract
AIM: This study examined the aspects of the nurse practice environment and patient safety climate and the various job dimensions that contribute to the occurrence of missed nursing care. BACKGROUND: Missed nursing care is a crucial healthcare concern that poses significant threats to patient safety. The available literature on missed nursing care is confined to high-resource nations, where hospital policies, mechanisms and processes to support professional nursing practice are well established. METHODS: This is a multi-centre, cross-sectional study, using self-report scales, which involves 624 clinical nurses in selected hospitals in the Philippines. RESULTS: Patient safety climate (β = -0.148, p = 0.001), decision authority (β = -0.101, p = 0.018) and staffing/resource adequacy (β = -0.086, p = 0.014) significantly predicted missed nursing care. Nurse, unit and hospital variables were not related with missed nursing care. DISCUSSION: Nurses who perceived greater decision authority, positive safety climate and adequate staffing/resources were less likely to miss or omit patient care activities. CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY: Institutional measures to foster decision authority in nurses, improve safety climate and address staffing/resource issues can be a viable solution to reduce the occurrence of missed nursing care.