Nursing practice environment and missed care at highly specialised hospitals in Mexico: A cross-sectional observational study.

Autor: Zárate-Grajales RA; National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico., Benítez-Chavira LA; National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico., Hernández-Corral S; National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico.; National Institute of Rehabilitation, Mexico City, Mexico., Serván-Mori E; National Institute of Public Health, Cuernavaca, Mexico., Nigenda G; National School of Nursing and Obstetrics (ENEO), National Autonomous University of Mexico (UNAM), Mexico City, Mexico., Amaya-Aguilar JA; National Institute of Cardiology, Mexico City, Mexico., Interial-Gúzman MG; National Autonomous University of Nuevo León (UANL), Monterrey, Mexico., Fabián-Victoriano R; General Hospital Dr. Manuel Gea González, Mexico City, Mexico., López-Cruz EA; Jesus Hospital, Mexico City, Mexico., Ortíz-López G; National Institute of Neurology and Neurosurgery, Mexico City, Mexico., Moreno-Monsiváis MG; National Autonomous University of Nuevo León (UANL), Monterrey, Mexico.
Jazyk: angličtina
Zdroj: The International journal of health planning and management [Int J Health Plann Manage] 2023 May; Vol. 38 (3), pp. 628-642. Date of Electronic Publication: 2022 Dec 20.
DOI: 10.1002/hpm.3606
Abstrakt: Background: The influence of the work environment on missed care and service quality has been well documented. However, available evidence concerning this relationship comes mostly from developed countries. Few studies have been conducted in low- or middle-income countries. We assessed the relationship between the work environment and missed nursing care in highly specialised hospitals in Mexico.
Methods: We conducted an observational cross-sectional study with data collected from January 2019 to February 2020 in 11 highly specialised hospitals (n = 510 nurses). We estimated missed nursing care utilising the MISSCARE questionnaire and used the Practice Environment Scale-Nursing Work Index instrument to assess the work environment. After describing the main attributes of the study sample according to the type of work environment, we constructed five adjusted fractional regression models, the first concerning the overall index of missed care, and the others pertaining to its various dimensions.
Results: The sample analysed was balanced as regards adjustment variables according to the type of work environment. The adjusted estimates confirmed an inverse relationship between the missed care index and enjoying an enhanced, or favourable, work environment. Overall, the difference was 9 percentage points (pp); however, by dimension of missed care, the major differences between enhanced and attenuated, or unfavourable, work environments were registered for basic care, followed by patient education and discharge planning (4pp) and individual needs (8pp).
Conclusions: The work environment determines the frequency of missed nursing care, both overall and by dimension. Nursing managers need to create short- and mid-term strategies favouring positive work environments in order to improve working conditions for nursing professionals.
(© 2022 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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