Systematic review finds supportive work environments associate with less missed nursing care, highlighting organizational factors in patient safety.
Key Points
Quantify the statistical association between nursing work environments and the occurrence of missed or omitted nursing care.
Systematic search across PubMed, Scopus, Web of Science, and APA PsycInfo identified 40 quantitative studies examining nursing practice environments and omitted care.
Conducted a random-effects meta-analysis with restricted maximum likelihood (REML) estimation on 15 studies (N = 7,100 participants) using Pearson correlation.
Performed post hoc sensitivity analyses including Hartung-Knapp adjustment, leave-one-out models, meta-regression, and small-study effect assessments.
A favorable nursing work environment was significantly associated with less missed nursing care (r = −0.301, 95% CI −0.402 to −0.192, p < 0.001; Hartung-Knapp adjusted 95% CI −0.411 to −0.182, p < 0.001).
Substantial heterogeneity was observed across studies (I² = 95.7%), with a 95% prediction interval spanning from −0.641 to 0.139, which crossed the null.