Nursing Professional Commitment as a Mediator of the Relationship Between Work Environment and Missed Nursing Care Among Nurses: A Cross-Sectional Analysis

Background & aims Missed nursing care is a global challenge that can have many consequences and it’s known as a common threat to the patient safety and quality of nursing care. The nurses’ professional commitment plays the final role in the occurrence of this issue. This study aimed to investigate the relationship between nurses’ professional commitment and missed nursing care in Iran. Materials & methods This cross-sectional descriptive-analytical study was conducted on 270 nurses working in two hospitals affiliated to Tehran University of Medical Sciences (Sina & Shariati) from September to December 2023. The research community included all nurses working in medical-surgical wards in the designated hospitals. The research samples were included in a targeted and quota method after obtaining organizational permits, ethical approval and informed consent. Data collection was done using three questionnaires including demographic information form, Nursing Professional Commitment Scale, and MISSCARE Questionnaire. The collected data was analyzed in SPSS software, version 25. Results The results of Pearson’s correlation test showed that there is a significant negative relationship between nurses’ professional commitment and missed nursing care scores ( r =-0.23) ( p < 0.001). The mean score of nurses’ professional commitment was reported at a moderate to high level (83.72 ± 16.02) and the mean score of missed nursing care was reported at a low level (47.84 ± 16.48). Nurses over 40 years old, morning shift and employed nurses showed higher professional commitment. Also, nurses under 29 years old and male nurses had more missed nursing care other than their participants. No relationship was observed between other demographic variables with nurses’ professional commitment and missed nursing care. Conclusion The results of this study showed that higher nurses’ professional commitment leads to higher quality of care and less missed nursing care. Based on findings of this research, it is recommended for health care providers and nursing managers to adopt programs to increase nurses’ professional commitment and consequently reduce missed nursing care.

The relationship between nurses’ professional commitment and missed nursing care: a cross-sectional study in Iran

Ahmadzadeh-Zeidi,

Rooddehghan,

Haghani

2024

Investigating the relationship between missed/rationed nursing care and organizational commitment in Iranian nurses

Babaei,

Nayeri,

Hajibabaee

et al. 2024

Background and objective The primary objective of the nursing profession is to provide comprehensive and appropriate nursing care that meets the individual needs of patients. However, instances of missed/rationed nursing care can jeopardize the delivery of complete and safe healthcare, potentially putting patients’ lives at risk. The level of organizational commitment demonstrated by nurses is likely to impact various personnel and organizational factors. Therefore, this study aims to predict instances of missed/rationed nursing care by examining the influence of organizational commitment. Method This descriptive and cross-sectional study will be conducted in 2023. Three hundred nurses working in general and intensive critical care units at Tehran University of Medical Sciences hospitals were randomly selected. Data collection included Allen and Mayer’s organizational commitment questionnaires, Kalish’s missed care questionnaire, and demographic variables. A multiple linear regression model was used to analyze the prediction of missed care by commitment and other variables. The relationship between these variables was also explored using SPSS version 26 software. Findings Half of the nurses reported occasionally missing nursing care. Moreover, more than half of the nurses reported moderate organizational commitment in all dimensions. The most significant reasons identified by nurses for missed care were financial resources, human resources, and communication ( p < 0.001). There was a significant relationship between missed/rationed nursing care and organizational commitment ( p = 0.042). In the multiple regression equation, a significant portion of missed care due to commitment was predicted when considering demographic variables ( p < 0.001). Conclusion By understanding the relationship between organizational commitment and missed care, and identifying the factors contributing to missed/rationed care, managers can improve the efficiency of human resources and allocate appropriate financial resources. Establishing effective communication with employees can also enhance their commitment to addressing neglected care, ultimately reducing instances of oversight.

The effect of toxic leadership on workplace deviance: the mediating effect of emotional exhaustion, and the moderating effect of organizational cynicism

Ahmed,

Atta,

El-Monshed

et al. 2024

Background Toxic leadership is abusive, destructive, and detrimental to nurses, can decrease nurse morale, increase stress levels, diminish organizational performance, and cause employee emotional exhaustion. Emotional exhaustion, a key component of burnout, has been linked to decreased job performance and increased likelihood of engaging in deviant behaviors at work. Organizational cynicism, as a negative attitude or distrust towards the organization and its leadership, may exacerbate the relationship between toxic leadership and workplace deviance. This study aims to explore how toxic leadership, workplace deviance, emotional exhaustion, and organizational cynicism are interrelated in the nursing profession. Method A multicenter descriptive, cross-sectional research design was conducted at three university hospitals affiliated with three Egyptian governorates: Zagazig, El-Fayoum, and Alexandria. Two hundred forty-three nurses completed the Personal and Job-related Data Questionnaire, Toxic Leadership Scale, Emotional Exhaustion Scale, Workplace Deviance Scale, and Organizational Cynicism Scale. Mediation analysis using SPSS PROCESS revealed that emotional exhaustion indirectly influences the relationship between toxic leadership and workplace deviance, while hierarchical multiple regression showed that organizational cynicism moderates this relationship, with linear regression confirming the predictive impact of these variables on workplace deviance. Results Toxic leadership exhibits a substantial positive influence on workplace deviance (B = 16.132, p < 0.001), as does emotional exhaustion (B = 8.760, p < 0.001) and organizational cynicism (B = 5.376, p = 0.036). Furthermore, the interaction terms of toxic leadership, organizational cynicism, and emotional exhaustion are significant (B = -3.012, p = 0.036). The negative coefficient of the interaction term implies a mitigating impact, indicating that the combined presence of high toxic leadership, high emotional exhaustion, and high organizational cynicism may counterintuitively reduce workplace deviance (t = -2.110). Conclusion These results suggest that while toxic leadership, emotional exhaustion, and organizational cynicism each independently increase workplace deviance, their combined presence may unexpectedly reduce deviant behaviors. Implication for nursing These results highlight the significance of tackling toxic leadership practices and cultivating a positive organizational culture to enhance a healthier work environment and reduce instances of workplace deviance. Healthcare settings should prioritize interventions to improve leadership practices, enhance employee well-being, and cultivate a supportive organizational climate.