Labrague Leodoro J, Al Sabei Sulaiman, AbuAlRub Raeda, Burney Ikram, Al Rawajfah Omar
School of Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA.
Fundamentals and Administration Department, College of Nursing, Sultan Qaboos University, Seeb, Oman.
J Nurs Scholarsh. 2025 Mar;57(2):354-362. doi: 10.1111/jnu.13017. Epub 2024 Aug 19.
While the nurse practice environment's vital role in shaping patient care outcomes is well established, the precise mechanisms through which it influences missed nursing care remain unexplored. Hence, this study examined the mediating role of adherence to clinical safety guidelines in the relationship between the nurse practice environment and missed nursing care.
This descriptive, cross-sectional study involved 1237 nurses from 11 governorates in the Sultanate of Oman. Data were collected using three standardized scales: the Patient Safety Adherence Scale, the Practice Environment Scale of the Nursing Work Index, and the Missed Nursing Care Scale.
A favorable nurse practice environment was associated with higher adherence to clinical safety guidelines (β = 2.492, p < 0.001) and a lower frequency of missed nursing care (β = -0.2919, p = 0.015). Adherence to clinical safety guidelines partially mediated the relationship between the nurse practice environment and missed nursing care (β = -0.055, p < 0.001).
Enhancing the nurse practice environment plays a crucial role in improving nurses' adherence to clinical safety guidelines, which in turn reduces compromised nursing care.
Healthcare administrators and policymakers should prioritize improving working conditions to enhance nurses' adherence to clinical safety guidelines, thereby minimizing the occurrence of missed care and improving overall patient outcomes.
虽然护士执业环境在塑造患者护理结果方面的重要作用已得到充分确立，但其影响护理缺失的具体机制仍未得到探索。因此，本研究探讨了遵守临床安全指南在护士执业环境与护理缺失之间关系中的中介作用。
这项描述性横断面研究涉及阿曼苏丹国11个省的1237名护士。使用三个标准化量表收集数据：患者安全遵从不全量表、护理工作指数执业环境量表和护理缺失量表。
良好的护士执业环境与更高的临床安全指南依从性（β = 2.492，p < 0.001）和更低的护理缺失频率（β = -0.2919，p = 0.015）相关。遵守临床安全指南部分中介了护士执业环境与护理缺失之间的关系（β = -0.055，p < 0.001）。
改善护士执业环境在提高护士对临床安全指南的依从性方面起着关键作用，这反过来又减少了护理缺失。
医疗保健管理人员和政策制定者应优先改善工作条件，以提高护士对临床安全指南的依从性，从而减少护理缺失的发生并改善整体患者结局。
