Aim: The main aim of the research was to describe and compare unfinished nursing care in selected European countries. Background: The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities. Methods: A cross-sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia). Results: The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care. Conclusion: The research results confirmed the prevalence of unfinished nursing care in the countries surveyed. Implications for Nursing Management: The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care.

Results highlight the importance of understanding nurses' leaving intentions and related factors and their impact on nurses' lives in both countries so that health care organizations can implement effective strategies to improve the retention of their nursing workforce.

BackgroundNursing shortages, the substitution of practical nurses for registered nurses, an ageing workforce, the decreasing number of nurse graduates and the increasing migration of young nurses are important factors associated with the hospital safety climate in Central European countries.AimsThe aim of the study was to investigate nurses’ perceptions of the safety climate in four selected central European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine the relationship between safety climate and unfinished nursing care.MethodsA cross‐sectional study was used. The sample consisted of 1353 European nurses from four countries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived Implicit Rationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses.ResultsSignificant differences were found between countries in all unit/hospital/outcome dimensions. ‘Perceived Patient Safety’ and ‘Reporting of Incident Data’ were associated with aspects of ‘Organizational Learning’ and ‘Feedback and Communication about Error’. Higher prevalence of unfinished nursing care is associated with more negative perceptions of patient safety climate.ConclusionsCross‐cultural comparisons allow us to examine differences and similarities in safety dimensions across countries. The areas with potential for initiating strategies for improvement in all four countries are ‘Staffing’, ‘Non‐punitive Response to Error’ and ‘Teamwork across Hospital Units’.Implications for nursing and health policy‘Feedback and Communicating about Error’ and ‘Organizational Learning ‐ Continuous Improvement’ were the main predictors of ‘Overall Perception of Patient Safety’ and ‘Reporting of Incident Data’. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no‐blame culture and effective reporting. In addition, it is important for policymakers to update nursing education standards in order to address patient safety.

Job satisfaction and leaving intentions of midwives: analysis of a multinational cross-sectional surveyAim To investigate the relationship between turnover intentions and job satisfaction among hospital midwives from seven countries and to determine how the related variables differ between countries. Background Studies investigating professional turnover and job satisfaction among midwives are limited in scope. Method A cross-sectional descriptive survey was used to investigate the intended turnover and job satisfaction relationship among 1190 hospital midwives in European and Asian countries. Data were collected using a set of questionnaires that included questions regarding the leaving intentions of midwives and the McCloskey/Mueller satisfaction scale. Results Midwives were least satisfied with their extrinsic rewards and professional opportunities and with the balance between family and work. Significant differences were found in all domains of job satisfaction according to midwives' intentions to leave their current workplace in hospital or profession of midwife, and to work abroad. Conclusion There are some general satisfying and dissatisfying elements for the profession of midwife across different countries. Implications for nursing management The results highlight the importance of understanding midwives' leaving intentions and related factors across different countries. To prevent midwife turnover, health-care managers should gain greater insight into the early stage of midwives' turnover intention.Keywords: job satisfaction, midwifery, turnover intention Overview of the literatureThe turnover of health-care workers and related determinants have been of interest to researchers from different disciplines for several decades (Coomber & Barriball 2007, Hasselhorn et al. 2008, Simon et al. 2010, Hayes et al. 2012). Ajzen's (1991) theory of planned behaviour has explained factors that predict actual turnover and describe the relationships between a person's attitudes, intentions and turnover behaviour. Attitudes towards behaviour, subjective norms and perceptions of behavioural control have been identified as predictors (i.e. antecedents) of behavioural intentions (Ajzen 1991). Based on this theory, Coomber and Barriball (2007) argued that the cognitive process of turnover intention (i.e. intent to leave) was an important predictor of actual turnover. According to Takase (2010), turnover intent is often triggered by negative psychological responses to organisational, work-related, employment factors or external (i.e. work-life balance) aspects of a job. The psychological responses evolve into gradual withdrawal cognition and behaviours, and lead to actual turnover (Takase 2010).The psychological component of turnover intention is the starting point of the multi-stage turnover reaction (Takase 2010). Coomber and Barriball (2007) described turnover intention (or intent to leave/stay)

The related phenomena of missed, rationed and unfinished care represent a critical global threat to patient safety and quality of nursing care. It has been established that in the provision of nursing care, unfinished care may lead to negative patient outcomes (Jones, Hamilton, & Murry, 2015) and a reduction in the quality of nursing care and patient safety (Griffiths et al., 2018). Nurses want to provide patient care that is both safe and of high quality and are required by professional standards to provide their patients with appropriate and courteous care while maintaining the quality and safety of that care (Vryonides, Papastavrou,