Determinants of missed nursing care: the role of teamwork and job satisfaction among Malaysian nurses

Abstract

Introduction: Multiple studies have found that missed nursing care (MNC) is related to the characteristics of nurses, the level of teamwork, and nurses' job satisfaction. This study aimed to determine the relationship between nurses' characteristics, teamwork, job satisfaction, and missed nursing care (MNC) among nurses at a public hospital in Malaysia. Methods: This cross-sectional study used the MISSCARE and Nursing Teamwork Surveys (NTS) and involved 260 nurses from three departments in a Malaysian public hospital. Descriptive analysis and inferential statistics were conducted to measure the research objectives of this study. Results: The most frequently missed nursing care activity was patients’ two-hourly turning (M=2.89, SD=0.96), and the least commonly reported MNC was blood glucose monitoring (M=1.30, SD=0.62). The most frequently reported reason for MNC was emotional and physical exhaustion (M=3.23, SD=0.92), whereas the least commonly reported reason was the unavailability of the unit manager (M=2.27, SD=0.99). Hierarchical multiple regression showed that demographic and work-related variables explained 11.4% of the variance in the data. Adding teamwork and satisfaction significantly improved the model, explaining 29.7% of the variance (R2 Change = 0.183, p < 0.001). In the final model, teamwork (β = -0.378, p < 0.001) and satisfaction with the current position (β = -0.19, p = 0.001) were the strongest predictors. Conclusions: Higher levels of teamwork and job satisfaction are associated with reduced missed nursing care. Consequently, healthcare organizations should prioritize strategies that strengthen team dynamics and the work environment to improve patient safety and care quality.