Teamwork Style, Leadership Skills and Environmental factors that influence Missed Nursing Care

Abstract

ABSTRACT Title: Teamwork Style, Leadership Skills and Environmental factors that influence Missed Nursing Care Background: Inpatient nursing teams are constantly challenged and under pressure to provide safe, efficient and cost-effective care while maintaining high-quality standards. As a result, nursing teams cannot always complete all of their duties during their shift, this phenomenon is known as Missed Nursing Care (MNC). Reasons for MNC can be attributed to nurses’ work environment factors such as staffing, time to complete an intervention and using available resources. According to literature, teamwork and leadership are factors in inpatient care that positively can influence quality of care and reduce MNC. To achieve effective teamwork in hospitals, it is necessary to understand what teamwork is and how it is performed in nursing wards. Aim: To explore how nursing teams in clinical inpatient nursing wards use leadership skills regarding teamwork to prevent or reduce MNC and how teamwork is influenced by environmental factors. Method: This study employed an exploratory qualitative design based on online focus group interviews. Data were analyzed using thematic analysis. Results: Three online focus group interviews were performed with 16 clinical nurses from 4 Dutch hospitals. Themes demonstrated that working together, informal teaching, influence of formal and informal leaders and work environmental factors were vital for performing teamwork and reduced or prevented MNC. Further, results showed that nurses’ performance of leadership skills facilitated teamwork. Conclusion: This study showed how nurses performed teamwork and how teamwork can prevent or reduce MNC. Results can build on existing literature and provide a theoretical basis for suggestions and interventions regarding improvement programs. Recommendations: Creating awareness of the influence of teamwork, leadership skills and environmental factors on MNC and further research on and investment in nursing teams are therefore recommended.

Keywords: Missed Nursing Care, Focus Groups, Teamwork, Leadership Skills, Environmental Factors