Association of the Nurse Work Environment, Collective Efficacy, and Missed Care

West J Nurs Res. 2018 Jun;40(6):779-798. doi: 10.1177/0193945917734159. Epub 2017 Oct 5.

Abstract

Missed nursing care is a significant threat to quality patient care. Promoting collective efficacy within nurse work environments could decrease missed care. The purpose was to understand how missed care is associated with nurse work environments and collective efficacy of hospital staff nurses. A cross-sectional, convenience sample was obtained through online surveys from registered nurses working at five southwestern U.S. hospitals. Descriptive, correlational, regression, and path analyses were conducted ( N = 233). The percentage of nurses who reported that at least one care activity was missed frequently or always was 94%. Mouth care (36.0% of nurses) and ambulation (35.3%) were missed frequently or always. Nurse work environments and collective efficacy were moderately, positively correlated. Nurse work environments and collective efficacy were associated with less missed care (χ2 = 10.714, p = .0054). Fostering collective efficacy in the nurse work environment could reduce missed care and improve patient outcomes.

Keywords: health care; hospitals; organizational culture; registered nurses; surveys and questionnaires.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Cross-Sectional Studies
  • Female
  • Hospitals*
  • Humans
  • Male
  • Middle Aged
  • Nursing Staff, Hospital / standards*
  • Quality of Health Care / standards*
  • Surveys and Questionnaires
  • United States
  • Walking
  • Workplace / psychology
  • Workplace / standards*