Structural Equation Modeling of Associations Between Nursing Practice Environment And Missed Nursing Care

Abstract

Background: Missed nursing care (MNC) negatively impacts the quality of patient care. There may be a relationship between the nursing practice environment (NPE) and MNC; however, this relationship has not been examined in developing countries during the COVID-19 pandemic. Purpose: To determine the relationship between the NPE and MNC during the COVID-19 pandemic. Methods: A cross-sectional study of 300 participants was conducted in 4 teaching hospitals in Iran. Data were collected using a demographic and clinical form, the Nursing Professional Practice Environment Questionnaire, and MISSCARE survey and analyzed using structural equation modeling. Results: The hypothesized model was well fit, showing that 1 unit improvement of the NPE domains of patient-centered care, effective leadership, and policy transparency decreased MNC by 0.18, 0.12, and 0.05, respectively. Conclusion: The model confirmed the association between the dimensions of the NPE and MNC. These findings can assist health policymakers and nursing managers in improving the NPE.