How nurses practice leadership in dealing with missed nursing care in hospitals, an explorative qualitative study.

Nurses today experience an increasingly heavy workload and overload of daily tasks that force them to prioritize their care activities. Missed nursing care, which refers to nurses not being able to complete all necessary care, may lead to a serious threat to patient safety in hospitals. Nursing leadership may be seen as an essential factor in reducing missed nursing care. However, no research has of yet been done to determine how nurses practice leadership by influencing missed nursing care on their wards.
Therefore, this study aims to explore how nurses practice leadership in dealing with missed nursing care in hospitals.
Method. Nurses (n=16) were selected by purposive sampling from general wards in Dutch hospitals. Data were collected through semi-structured in-depth interviews. Thematic analysis was conducted.
Five themes were identified in the descriptions of nurses’ experiences of missed nursing care: dealing with unexpected and busy situations; being a patient advocate in decision-making; accepting the impossibility of completing all essential care; creating a safe, positive work environment; and taking control over one’s own tasks and workload. Nurses in this study experienced pressure to guarantee good-quality patient care in daily practice, and they have several ways of dealing with missed nursing care.
Conclusion: The study revealed that nurses recognize a need to develop certain leadership competencies for dealing with missed nursing care. Focused nurse leadership development will help ensure that nurses are well-equipped to meet the challenges of preventing missed nursing care in health care both now and in the future.