title: The Impact of the Nursing Practice Environment on Missed Nursing Care.
abstract: OBJECTIVE
  Missed nursing care is an emerging problem negatively impacting patient outcomes. There are gaps in our knowledge of factors associated with missed nursing care. The aim of this study was to determine the relationship between the nursing practice environment and missed nursing care in acute care hospitals.
  
  
  METHODS
  This is a secondary analysis of cross sectional data from a survey of over 7.000 nurses from 70 hospitals on workplace and process of care. Ordinary least squares and multiple regression models were constructed to examine the relationship between the nursing practice environment and missed nursing care while controlling for characteristics of nurses and hospitals.
  
  
  RESULTS
  Nurses missed delivering a significant amount of necessary patient care (10-27%). Inadequate staffing and inadequate resources were the practice environment factors most strongly associated with missed nursing care events.
  
  
  CONCLUSIONS
  This multi-site study examined the risk and risk factors associated with missed nursing care. Improvements targeting modifiable risk factors may reduce the risk of missed nursing care.
authors.affiliation: School of Nursing, Columbia University, New York, USA.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Hessels
authors.affiliation: College of Nursing, University of Colorado Denver, Colorado, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Flynn
authors.affiliation: College of Nursing, University of Florida, Florida USA.
authors.forename: Jeannie P
authors.initials: JP
authors.lastname: Cimiotti
authors.affiliation: School of Nursing, Rutgers University, New Jersey, USA.
authors.forename: Edna
authors.initials: E
authors.lastname: Cadmus
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, California, USA.
authors.forename: Robyn R M
authors.initials: RR
authors.lastname: Gershon
keywords: hospital; missed nursing care; practice environment