Association between the practice environment and missed nursing care in the emergency room

The demanding and intricate practice environment affects the nursing care provided in the emergency room.

To investigate the relationship between the practice environment and missed nursing care in the emergency room while identifying the impact of sociodemographic and work-related factors.

A cross-sectional study was conducted involving 102 emergency room nursing staff at a public hospital in São Paulo state, Brazil. Data collection included administering the Misscare-Brazil survey and the Practice Environment Scale.

The sample consisted of 28 nurses and 74 nursing technicians. Most were women (n = 89; 87.3 %); the largest segment had a high school education (n = 48; 47.1 %). The mean score on the Practice Environment Scale was 2.17 (±0.60). The multivariate analysis indicated that the practice environment was influenced by workload (p < 0.001), experience in the profession (p = 0.013), experience in the sector (p = 0.029), extra hours (p = 0.005), adequate employee numbers (p = 0.001), job satisfaction (p = 0.033), satisfaction with the profession (p = 0.016), and Part A of the Misscare-Brazil survey (p < 0.001). The mean number of care omissions was 2.64 (± 0.77). It was independently associated with education level (p = 0.040), workload (p < 0.001), extra hours (p = 0.005), number of patients under care (p = 0.004), number of discharges (p = 0.010), and satisfaction with the profession (p = 0.037).

The perception of an unfavourable practice environment impacted personal and work-related factors and was linked to missed nursing care in the emergency room.