Linking nurse practice environment, safety climate and job dimensions to missed nursing care

Leodoro J. Labrague*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: This study examined the aspects of the nurse practice environment and patient safety climate and the various job dimensions that contribute to the occurrence of missed nursing care. Background: Missed nursing care is a crucial healthcare concern that poses significant threats to patient safety. The available literature on missed nursing care is confined to high-resource nations, where hospital policies, mechanisms and processes to support professional nursing practice are well established. Methods: This is a multi-centre, cross-sectional study, using self-report scales, which involves 624 clinical nurses in selected hospitals in the Philippines. Results: Patient safety climate (β = −0.148, p = 0.001), decision authority (β = −0.101, p = 0.018) and staffing/resource adequacy (β = −0.086, p = 0.014) significantly predicted missed nursing care. Nurse, unit and hospital variables were not related with missed nursing care. Discussion: Nurses who perceived greater decision authority, positive safety climate and adequate staffing/resources were less likely to miss or omit patient care activities. Conclusion and implications for nursing and health policy: Institutional measures to foster decision authority in nurses, improve safety climate and address staffing/resource issues can be a viable solution to reduce the occurrence of missed nursing care.

Original languageEnglish
JournalInternational Nursing Review
Publication statusAccepted/In press - 2021
Externally publishedYes


  • decision authority
  • missed care
  • nursing
  • Philippines
  • safety climate
  • work environment

ASJC Scopus subject areas

  • Nursing(all)

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