PRODUCTIVITY ATTITUDES AND MISSED NURSING CARE AMONG HEATHCARE PROFESSIONELS IN TURKIYE
DOI:
https://doi.org/10.5281/zenodo.23159919Keywords:
Healthcare Professionals, Missed Nursing Care, Patient Safety, Productivity, WorkloadAbstract
Healthcare professionals’ productivity attitudes and missed nursing care are important organizational indicators of care quality, patient safety, and workforce sustainability. This study aimed to evaluate productivity attitudes and perceptions of missed nursing care among healthcare professionals, determine whether these scores differed according to demographic and professional characteristics, and examine the relationships between productivity dimensions and missed nursing care. A descriptive cross-sectional design was used. The study included 1,591 healthcare professionals working in healthcare institutions primarily located in the Black Sea and Marmara regions of Türkiye. Data were collected through an online questionnaire comprising a demographic information form, the Nurses’ Attitude Scale on Productivity, and the MISSCARE Survey. Descriptive statistics, Mann–Whitney U tests, Kruskal–Wallis tests, Spearman’s rank correlation analyses, and Cronbach’s alpha coefficients were used. The productivity scale and MISSCARE Survey demonstrated high internal consistency, with Cronbach’s alpha coefficients of .850 for the productivity scale, .974 for MISSCARE Part A, and .940 for MISSCARE Part B. Productivity and missed care scores differed significantly according to selected demographic and professional characteristics, including marital status, education level, professional field, and employment position. Work environment conditions, workload distribution, staffing adequacy, material resources, communication, and employment responsibilities were prominent organizational factors associated with missed nursing care. More positive productivity attitudes were generally associated with fewer organizational reasons for missed care, although the direction and strength of associations varied across scale dimensions. These findings indicate that missed nursing care should be addressed as an organizational and managerial issue rather than solely as an individual performance problem. Evidence-based workforce planning, supportive leadership, adequate resource allocation, and stronger interprofessional communication may improve productivity and reduce missed nursing care.
References
Abugre, D., & Bhengu, B. R. (2024). Nurse managers' perceptions of patient-centred care and its influence on quality nursing care and nurse job satisfaction = Empirical research qualitative. Nursing Open, 11(1), Article e2071.
Aust, B., Møller, J. L., Nordentoft, M., Frydendall, K. B., Bengtsen, E., Jensen, A. B., Kristiansen, J., & Jaspers, S. Ø. (2023). How effective are organizational-level interventions in improving the psychosocial work environment, health, and retention of workers? A systematic overview of systematic reviews. Scandinavian Journal of Work, Environment & Health, 49(5), 315–329.
Babapour, A. R., Gahassab-Mozaffari, N., & Fathnezhad-Kazemi, A. (2022). Nurses' job stress and its impact on quality of life and caring behaviors: A cross-sectional study. BMC Nursing, 21, Article 75.
Bruyneel, A., Bouckaert, N., Pirson, M., Sermeus, W., & Van den Heede, K. (2024). Unfinished nursing care in intensive care units and the mediating role of the association between nurse working environment, and quality of care and nurses' wellbeing. Intensive and Critical Care Nursing, 81, Article 103596.
Chaboyer, W., Harbeck, E., Lee, B. O., & Grealish, L. (2021). Missed nursing care: An overview of reviews. The Kaohsiung Journal of Medical Sciences, 37(2), 82–91.
Data Protection Act (1050/2018) (Fin.). Finlex. https://www.finlex.fi/en/laki/kaannokset/2018/en20181050.pdf
Dutra, C. K. D. R., & Guirardello, E. D. B. (2021). Nurse work environment and its impact on reasons for missed care, safety climate, and job satisfaction = A cross-sectional study. Journal of Advanced Nursing, 77(5), 2398–2406.
Eastaugh, S. R. (2007). Hospital nurse productivity enhancement. Journal of Health Care Finance, 33(3), 39–47.
European Parliament and Council of the European Union. (2018). Regulation (EU) 2018/1725 on the protection of natural persons with regard to the processing of personal data by the Union institutions, bodies, offices and agencies and on the free movement of such data. http://data.europa.eu/eli/reg/2018/1725/oj
Göktepe, N., & Baykal, Ü. (2012). Verimliliğe ilişkin tutum ölçeğinin geliştirilmesi. Hemşirelikte Araştırma Geliştirme Dergisi, 14(2), 29–41.
Griffiths, P., Saville, C., Ball, J., Dall'Ora, C., Meredith, P., Turner, L., & Jones, J. (2023). Costs and cost-effectiveness of improved nurse staffing levels and skill mix in acute hospitals: A systematic review. International Journal of Nursing Studies, 147, Article 104601. https://doi.org/10.1016/j.ijnurstu.2023.104601
Hessels, A. J., Flynn, L., Cimiotti, J. P., Cadmus, E., & Gershon, R. R. (2015). The impact of the nursing practice environment on missed nursing care. Clinical Nursing Studies, 3(4), 60–65.
Imam, A., Obiesie, S., Gathara, D., Aluvaala, J., Maina, M., & English, M. (2023). Missed nursing care in acute care hospital settings in low-income and middle-income countries: A systematic review. Human Resources for Health, 21, Article 19.
Jensen, I., Arapovic-Johansson, Z., & Aboagye, E. (2022). The cost-effectiveness analysis of the Productivity Measurement and Enhancement System intervention to reduce employee work-related stress and enhance work performance. International Journal of Environmental Research and Public Health, 19(4), Article 2431.
Kalisch, B. J., & Lee, K. H. (2011). Nurse staffing levels and teamwork: A cross-sectional study of patient care units in acute care hospitals. Journal of Nursing Scholarship, 43(1), 82–88.
Kalisch, B. J., Terzioglu, F., & Duygulu, S. (2012). The MISSCARE survey-Turkish: Psychometric properties and findings. Nursing Economics, 30(1), 29–37.
Kalisch, B. J., & Williams, R. (2009). Development and psychometric testing of a tool to measure missed nursing care (MISSCARE survey). Journal of Nursing Administration, 39(5), 211–219.
Kosklin, R., Lammintakanen, J., & Kivinen, T. (2023). Knowledge management effects and performance in health care: A systematic literature review. Knowledge Management Research & Practice, 21(4), 738–748.
Lee, M., & Cha, C. (2023). Interventions to reduce burnout among clinical nurses: Systematic review and meta-analysis. Scientific Reports, 13, Article 10971.
Maghsoud, F., Rezaei, M., Asgarian, F. S., & Rassouli, M. (2022). Workload and quality of nursing care: The mediating role of implicit rationing of nursing care, job satisfaction and emotional exhaustion by using structural equations modeling approach. BMC Nursing, 21, Article 273.
Palese, A., Bassi, E., Tommasini, C., Vesca, R., Di Falco, A., De Lucia, P., & Blackman, I. (2019). Developing policies and actions in response to missed nursing care: A consensus process. Journal of Nursing Management, 27(7), 1492–1504.
Papathanasiou, I., Tzenetidis, V., Tsaras, K., Zyga, S., & Malliarou, M. (2024). Missed nursing care; prioritizing the patient's needs: An umbrella review. Healthcare, 12(2), Article 224.
Poku, C. A., Donkor, E., & Naab, F. (2022). Impacts of nursing work environment on turnover intentions: The mediating role of burnout in Ghana. Nursing Research and Practice, 2022, Article 1310508.
Rodriguez-Arrastia, M., García-Martín, M., Villegas-Aguilar, E., Ropero-Padilla, C., Martin-Ibañez, L., & Roman, P. (2022). Emotional and psychological implications for healthcare professionals in disasters or mass casualties: A systematic review. Journal of Nursing Management, 30(1), 298–309.
Specchia, M. L., Cozzolino, M. R., Carini, E., Di Pilla, A., Galletti, C., Ricciardi, W., & Damiani, G. (2021). Leadership styles and nurses' job satisfaction. Results of a systematic review. International Journal of Environmental Research and Public Health, 18(4), Article 1552.
Stavropoulou, A., Rovithis, M., Kelesi, M., Vasilopoulos, G., Sigala, E., Papageorgiou, D., Moudatsou, M., & Koukouli, S. (2022). What quality of care means? Exploring clinical nurses' perceptions on the concept of quality care: A qualitative study. Clinics and Practice, 12(4), 468–481.
World Medical Association. (2013). WMA Declaration of Helsinki – Ethical principles for medical research involving human subjects. JAMA, 310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
Yu, C., Xian, Y., Jing, T., Bai, M., Li, X., Li, J., Yao, J., & Zhang, Z. (2023). More patient-centered care, better healthcare: The association between patient-centered care and healthcare outcomes in inpatients. Frontiers in Public Health, 11, Article 1148277.
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