BACKGROUND: Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID-19 pandemic. AIMS: The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID-19 pandemic. METHODS: A cross-sectional study was used. The RANCARE guideline and STROBE checklist were followed for reporting in the study. The sample consisted of 371 nurses from four acute care hospitals. The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data. The data were analyzed using multiple linear and logistic regression analyses. RESULTS: Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care. Prevalence estimates of missed care in Czech acute care hospitals during the COVID-19 pandemic was predicted from the overtime work, the nurses' perception of the "Nursing foundations for the quality of care," and their satisfaction with their current position. CONCLUSIONS: Missed nursing care could be mitigated by improving the nurses' work environment. Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care. IMPLICATIONS FOR NURSING POLICY: Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses' concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers.

Department of Nursing Faculty of Health Sciences Palacký University in Olomouc Olomouc Czech Republic

Zobrazit více v PubMed

Aiken, L.H. , Sloane, D.M. , Ball, J. , Bruyneel, L. , Rafferty, A.M. & Griffiths, P. (2018) Patient satisfaction with hospital care and nurses in England: An observational study. BMJ Open, 8, e019189. 10.1136/bmjopen-2017-019189 PubMed DOI PMC

Ausserhofer, D. , Zander, B. , Busse, R. , Schubert, M. , De Geest, S. , Rafferty, A.M. et al. (2014) Prevalence, patterns and predictors of nursing care left undone in European hospitals: Results from the multicountry cross‐sectional. RN4CAST study. BMJ Quality & Safety, 23, 126–135. 10.1136/bmjqs-2013-002318 PubMed DOI

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, 116–125. 10.1136/bmjqs-2012-001767 PubMed DOI PMC

Bagnasco, A. , Catania, G. , Zanini, M. , Dasso, N. , Rossi, S. , Aleo, G. et al. (2020) Are data on missed nursing care useful for nursing leaders? The RN4CAST@IT cross‐sectional study. Journal of Nursing Management, 28, 2136–2145. 10.1111/jonm.13139 PubMed DOI

Ball, J.E. , Griffiths, P. , Rafferty, A.M. , Lindqvist, R. , Murrells, T. & Tishelman, C. (2016) A cross‐sectional study of ‘care left undone’ on nursing shifts in hospitals. Journal of Advanced Nursing, 72, 2086–2097. 10.1111/jan.12976 PubMed DOI

Ball, J.E. , Bruyneel, L. , Aiken, L.H. , Sermeus, W. , Sloane, D.M. et al. (2018) Post‐operative mortality, missed care and nurse staffing in nine countries: A cross‐sectional study. International Journal of Nursing Studies, 78, 10–15. 10.1016/j.ijnurstu.2017.08.004. PubMed DOI PMC

Bruyneel, L. , Li, B. , Ausserhofer, D. , Lesaffre, E. , Dumitrescu, I. , Smith, H.L. et al. (2015) Organization of hospital nursing, provision of nursing care, and patient experiences with care in Europe. Medical Care Research and Review, 72, 643–664. 10.1177/1077558715589188. PubMed DOI PMC

Bragadóttir, H. , Kalisch, B.J. & Tryggvadóttir, G.B. (2017) Correlates and predictors of missed nursing care in hospitals. Journal of Clinical Nursing, 26, 1524–1534. 10.1111/jocn.13449 PubMed DOI

Campbell, C.M. , Prapanjaroensin, A. , Anusiewicz, C.V. , Baernholdt, M. , Jones, T. & Patrician, P.A. (2020) Variables associated with missed nursing care in Alabama: A cross‐sectional analysis. Journal of Nursing Management, 28, 2174–2184. 10.1111/jonm.12979 PubMed DOI

Duffy, J.R. , Culp, S. & Padrutt, T. (2018) Description and factors associated with missed nursing care in an acute care community hospital. Journal of Nursing Administration, 48, 361–367. 10.1097/NNA.0000000000000630 PubMed DOI

Fernandez, R. , Lord, H. , Halcomb, E. , Moxham, L. , Middleton, R. , Alananzeh, I. et al. (2020) Implications for COVID‐19: A systematic review of nurses’ experiences of working in acute care hospital settings during a respiratory pandemic. International Journal of Nursing Studies,103637, 111. 10.1016/j.ijnurstu.2020.103637 PubMed DOI PMC

Friganovic, A. , Režić, S. , Kurtović, B. , Vidmanić, S. , Zelenikova, R. , Rotim, C. et al. (2020) Nurses’ perception of implicit nursing care rationing in Croatia—A cross‐sectional multicentre study. Journal Of Nursing Management, 28, 2230–2239. 10.1111/jonm.13002 PubMed DOI

Griffiths, P. , Dall'ora, C. , Simon, M. , Ball, J. , Lindqvist, R. , Rafferty, A.‐.M. et al. (2014) Nurses’ shift length and overtime working in 12 European countries. Medical Care, 52, 975–981. 10.1097/MLR.0000000000000233 PubMed DOI PMC

Griffiths, P. , Recio‐Saucedo, A. , Dallʼora, C. , Briggs, J. , Maruotti, A. , Meredith, P. et al. (2018) The association between nurse staffing and omissions in nursing care: A systematic review. Journal of Advanced Nursing, 74, 1474–1487. 10.1111/jan.13564 PubMed DOI PMC

Gurková, E. , Adamkovič, M. , Jones, T. , Kurucová, R. , Kalánková, D. & Žiaková, K. (2020) Factor analysis, validity of the perceived implicit rationing of nursing care instrument and prevalence and patterns of unfinished nursing care in Slovakia. Journal of Nursing Management, 8, 2036–2047. 10.1111/jonm.12887 PubMed DOI

Gurková, E. , Bartoníčková, D. , Mikšová, Z. , Labudíková, M. & Chocholková, D. (2021) Reasons for unfinished nursing care from the perspective of nurses from regional and university hospitals. Kontakt, (in press). DOI: 10.32725/kont.2021.026. https://kont.zsf.jcu.cz/corproof.php?tartkey=knt‐000000‐0740 DOI

Havaei, F. , Ma, A. , Staempfli, S. & Macphee, M. (2021) Nurses’ workplace conditions impacting their mental health during COVID‐19: A cross‐sectional survey study. Healthcare, 9, 84. 10.3390/healthcare9010084 PubMed DOI PMC

Hessels, A.J. , Flynn, L. , Cimiotti, J.P. , Cadmus, E. & Gershon, R.R.M. (2015) The impact of the nursing practice environment on missed nursing care. Clinical Nursing Studies, 3, 60–65. 10.5430/cns.v3n4p60 PubMed DOI PMC

Jarošová, D. , Gurková, E. , Zeleníková, R. , Plevová, I. & Janíková, E. (2021) Hospital and unit variables of missed nursing care in acute care hospitals: A cross‐sectional study. Journal of Clinical Nursing, 30, 1099–1110. 10.1111/jocn.15655 PubMed DOI

Jones, T.L. , Hamilton, P. & Murry, N. (2015) Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal of Nursing Studies, 52, 1121–1137. 10.1016/j.ijnurstu.2015.02.012 PubMed DOI

Jones, T. , Willis, E. , Amorim‐Lopes, M. & Drach‐Zahavy, A. (2019) Advancing the science of unfinished nursing care: Exploring the benefits of cross‐disciplinary knowledge exchange, knowledge integration and transdisciplinarity. Journal of Advanced Nursing, 75(4), 905–917. 10.1111/jan.13948 PubMed DOI

Jones, T. , Drach‐Zahavy, A. , Sermeus, W. , Willis, E. & Zelenikova, R. (2021) Understanding missed care: Definitions, measures, conceptualizations, evidence, prevalence, and challenges. In Papastavrou E. & Suhonen R. (Eds.) Impacts of rationing and missed nursing care: Challenges and solutions (pp. 9–47). Springer International Publishing. 10.1007/978-3-030-71073-6_2. DOI

Kalánková, D. , Kirwan, M. , Bartoníčková, D. , Cubelo, F. , Žiaková, K. & Kurucová, R. (2020) Missed, rationed or unfinished nursing care: A scoping review of patient outcomes. Journal of Nursing Management, 28, 1783–1797. 10.1111/jonm.12978 PubMed DOI

Kalisch, B.J. & Williams, R.A. (2009a) Development and psychometric testing of a tool to measure missed nursing care. Journal of Nursing Administration, 39, 211–219. 10.1097/NNA.0b013e3181a23cf5. PubMed DOI

Kalisch, B.J. , Landstrom, G.L. & Hinshaw, A.S. (2009) Missed nursing care: A concept analysis. Journal of Advanced Nursing, 65, 1509–1517. 10.1111/j.1365-2648.2009.05027.x PubMed DOI

Kim, K.‐J. , Yoo, M.S. & Seo, E.J. (2018) Exploring the influence of nursing work environment and patient safety culture on missed nursing care in Korea. Asian Nursing Research, 12, 121–126. 10.1016/j.anr.2018.04.003 PubMed DOI

Kirwan, M. & Schubert, M. (2020) Missed or rationed nursing care: Where to now for the nurse manager? Journal of Nursing Management, 28, 1767–1769. 10.1111/jonm.13078 PubMed DOI

Lake, E.T. (2002) Development of the practice environment scale of the nursing work index. Research in Nursing and Health, 25, 176–188. 10.1002/nur.10032 PubMed DOI

Lake, E.T. , Sanders, J. , Duan, R. , Riman, K.A. , Schoenauer, K.M. & Chen, Y. (2019) A Meta‐analysis of the associations between the nurse work environment in hospitals and 4 sets of outcomes. Medical Care, 57, 353–361. 10.1097/MLR.0000000000001109 PubMed DOI PMC

Lake, E.T. , French, R. , O'rourke, K. , Sanders, J. & Srinivas, S.K. (2020a) Linking the work environment to missed nursing care in labour and delivery. Journal of Nursing Management, 28, 1901‐1908. 10.1111/jonm.12856 PubMed DOI PMC

Lake, E.T. , Riman, K.A. & Sloane, D.M. (2020b) Improved work environments and staffing lead to less missed nursing care: A panel study. Journal of Nursing Management, 28, 2157‐2165. 10.1111/jonm.12970 PubMed DOI PMC

Liu, X. , Zheng, J. , Liu, K. , Baggs, J.G. , Liu, J. , Wu, Y. et al. (2018) Hospital nursing organizational factors, nursing care left undone, and nurse burnout as predictors of patient safety: A structural equation modeling analysis. International Journal of Nursing Studies, 86, 82–89. 10.1016/j.ijnurstu.2018.05.005 PubMed DOI

Maloney, S. , Fencl, J.L. & Hardin, S.R. (2015) Is nursing care missed? A comparative study of three North Carolina hospitals. Medsurg nursing: official journal of the Academy of Medical‐Surgical Nurses, 24, 229–235. PubMed

Ministry of Health of the Czech Republic . (2021) COVID 19: Overview of the current situation in the Czech Republic. Available at: https://onemocneni‐aktualne.mzcr.cz/covid‐19 (Accessed 12 February 2021).

OECD/European Union . (2020) Health at a glance: Europe 2020: State of health in the EU cycle. Paris: OECD Publishing. Available at: https://ec.europa.eu/health/sites/default/files/state/docs/2020_healthatglance_rep_en.pdf (Accessed 11 June 2020)

Palese, A. , Ambrosi, E. , Prosperi, L. , Guarnier, A. , Barelli, P. , Zambiasi, P. et al. (2015) Missed nursing care and predicting factors in the Italian medical care setting. Internal and Emergency Medicine, 10, 693–702. 10.1007/s11739-015-1232-6 PubMed DOI

Palese, A. , Bassi, E. , Tommasini, C. , Vesca, R. , Di Falco, A. , De Lucia, P. et al. (2019) Developing policies and actions in response to missed nursing care: A consensus process. Journal of Nursing Management, 27, 1492–1504. 10.1111/jonm.12835 PubMed DOI

Papastavrou, E. , Andreou, P. & Efstathiou, G. (2014a) Rationing of nursing care and nurse patient outcomes: A systematic review of quantitative studies. International Journal of Health Planning and Management, 29, 3–25. 10.1002/hpm.2160 PubMed DOI

Papastavrou, E. , Andreou, P. , Tsangari, H. , Schubert, M. & De Geest, S. (2014b) Rationing of nursing care within professional environmental constraints: A correlational study. Clinical Nursing Research, 23, 314–335. 10.1177/1054773812469543 PubMed DOI

Park, S.H. , Hanchett, M. & Ma, C. (2018) Practice Environment Characteristics Associated with Missed Nursing Care. Journal of Nursing Scholarship, 50, 722–730. 10.1111/jnu.12434 PubMed DOI

Pereira Lima Silva, R. , Gonçalves Menegueti, M. , Dias Castilho Siqueira, L. , Araújo, T.R. , Auxiliadora‐Martins, M. , Mantovani Silva Andrade, L. et al. (2020) Omission of nursing care, professional practice environment, and workload in intensive care units. Journal of Nursing Management, 28, 1986–1996. 10.1111/jonm.13005 PubMed DOI

Rochefort, C.M. & Clarke, S.P. (2010) Nurses’ work environments, care rationing, job outcomes, and quality of care on neonatal units. Journal of Advanced Nursing, 66, 2213–2224. 10.1111/j.1365-2648.2010.05376.x PubMed DOI

Santos, J.L.G.D. , Balsanelli, A.P. , Freitas, E.D.O. , Menegon, F.H.A. , Carneiro, I.A. , Lazzari, D.D. et al. (2021) Work environment of hospital nurses during the COVID‐19 pandemic in Brazil. International Nursing Review, 68, 228–237. 10.1111/inr.12662 PubMed DOI PMC

Schubert, M. , Ausserhofer, D. , Desmedt, M. , Schwendimann, R. , Lesaffre, E. , Li, B. et al. (2013) Levels and correlates of implicit rationing of nursing care in Swiss acute care hospitals – A cross sectional study. International Journal of Nursing Studies, 50, 230–239. 10.1016/j.ijnurstu.2012.09.016 PubMed DOI

Scott, P.A. , Harvey, C. , Felzmann, H. , Suhonen, R. , Habermann, M. , Halvorsen, K. et al. (2019) Resource allocation and rationing in nursing care: A discussion paper. Nursing ethics, 26, 1528–1539. 10.1177/0969733018759831 PubMed DOI PMC

Smith, J.G. , Rogowski, J.A. & Lake, E.T. (2020a) Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care. Journal of Nursing Management, 28, 1940–1947. 10.1111/jonm.12943 PubMed DOI PMC

Smith, S. , Lapkin, S. , Sim, J. & Halcomb, E. (2020b) Nursing care left undone, practice environment and perceived quality of care in small rural hospitals. Journal of Nursing Management, 28, 2166–2173. 10.1111/jonm.12975 PubMed DOI

Smith, J.G. (2020c) Strategies for improving the nurse work environment during the COVID‐19 pandemic. Available at: https://www.myamericannurse.com/strategies-for-improving-the-nurse-work-environment-during-the-covid-19-pandemic/ [Accessed 15 December 2020].

Vanfosson, C.A. , Jones, T.L. & Yoder, L.H. (2018) Monthly variation of unfinished nursing care at the US Army Burn Center. Burns: Journal of the International Society for Burn Injuries, 44, 1910–1919. 10.1016/j.burns.2018.03.008 PubMed DOI

Von Vogelsang, A.‐C. , Göransson, K.E. , Falk, A.‐C. & Nymark, C. (2021) Missed nursing care during the COVID‐19 pandemic: A comparative observational study. Journal of Nursing Management. Accepted Author Manuscript. 10.1111/jonm.13392 PubMed DOI PMC

Willis, E. , Henderson, J. , Hamilton, P. , Toffoli, L. , Blackman, I. , Couzner, L. et al. (2015) Work intensification as missed care. Labour & Industry: a journal of the social and economic relations of work, 25(2), 118–133. 10.1080/10301763.2015.1060811 DOI

Willis, E. , Zelenikova, R. , Bail, K. & Papastavrou, E. (2021) The globalization of missed nursing care terminology. International Journal of Nursing Practice, 27, e12859. 10.1111/ijn.12859 PubMed DOI

Zeleníková, R. , Gurková, E. & Jarošová, D. (2019) Missed nursing care measured by MISSCARE Survey – the first pilot study in the Czech Republic and Slovakia. Central European Journal of Nursing and Midwifery, 10, 958–966. 10.15452/CEJNM.2019.10.0002 DOI

Zeleníková, R. , Gurková, E. , Friganovic, A. , Uchmanowicz, I. , Jarošová, D. , Žiaková, K. et al. (2020a) Unfinished nursing care in four central European countries. Journal of Nursing Management, 28, 1888–1900. 10.1111/jonm.12896 PubMed DOI PMC

Zeleníková, R. , Jarošová, D. , Plevová, I. & Janíková, E. (2020b) Nurses’ perceptions of professional practice environment and its relation to missed nursing care and nurse satisfaction. International Journal of Environmental Research and Public Health, 17, 3805‐3805. 10.3390/ijerph17113805 PubMed DOI PMC

Zeleníková, R. , Jarošová, D. , Plevová, I. , Janíková, E. , Polanská, A. & Mynaříková, E. (2021) Relationship between nursing practice environment and unfinished nursing care ‐ the first results of research in the Czech Republic. Zdravotnicke Listy, 9, 12–18.

Zhao, Y. , Ma, D. , Wan, Z. , Sun, D. , Li, H. & Sun, J. (2020) Associations between work environment and implicit rationing of nursing care: A systematic review. Journal of Nursing Management, 28, 1841–1850. 10.1111/jonm.12895 PubMed DOI

Perception of Work-Related Stress and Quality of Life among Nurses during COVID-19 Pandemic-An International, Multicenter Prospective Study