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Practice Environment Characteristics Associated With Missed Nursing Care.
Shin Hye Park1, Miranda Hanchett2, Chenjuan Ma3
1Assistant Professor School of Nursing, University of Kansas, Kansas City, KS, USA.
Summary
A positive practice environment significantly reduces missed nursing care. Improving staffing, resources, and nurse-physician relations are key to enhancing patient care quality.
Area of Science:
- Nursing Quality Indicators
- Healthcare Management
- Patient Safety Research
Background:
- Missed nursing care is a critical issue impacting patient outcomes.
- Understanding the influence of the practice environment is essential for quality improvement.
Purpose of the Study:
- To identify specific practice environment characteristics associated with missed nursing care in U.S. acute care hospitals.
- To quantify the relationship between environmental factors and the occurrence of missed nursing care.
Main Methods:
- Secondary analysis of the 2015 National Database of Nursing Quality Indicators Registered Nurse (RN) Survey.
- Utilized the Practice Environment Scale of the Nursing Work Index.
- Employed multilevel logistic regression with a sample of 31,650 RNs across 1,583 units.
Main Results:
- 84.1% of RNs reported missing at least one care activity.
- Good practice environments were associated with significantly lower odds of missed care (63.3% reduction).
- Improvements in staffing/resources and nurse-physician relations decreased missed care, while increased participation in hospital affairs raised it.
Conclusions:
- Positive practice environments are strongly linked to reduced missed nursing care.
- Targeting specific environmental factors like staffing, resources, and interprofessional relations can mitigate missed care.
- Hospital administrators should focus on optimizing the practice environment to improve patient care.
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