Nursing work environment and unfinished nursing care in hospital settings - a scoping review

Aim: This scoping review aimed to summarize the evidence regarding the relationship between the nursing work environment and unfinished nursing care, and to offer a deeper insight into organizational factors of unfinished nursing care in hospital settings. A further aim of the study was to collate evidence about instruments for measurement of nurses’ perceptions of the nursing work environment. Design: A scoping review was performed. Methods: A search was conducted in eight scientific databases. The final review included 22 studies and publications ranging from 2010 to 2020. Guidelines regarding scoping review methodology developed by the Joanna Briggs Institute were followed in our study. Results: The majority of studies included representative hospital and nurse samples, and had a cross-sectional design. Evidence indicates that the nursing work environment is a significant predictor of unfinished nursing care. The more favorable the nursing work environment, as perceived by nurses, the less frequently they reported unfinished nursing care events. The domains of the Practice Environment Scale of the Nursing Work Index were found to be significant predictors of unfinished nursing care. Conclusion: Nurses working in favorable conditions reported lower prevalence of unfinished nursing care. Improvements in staffing and resource adequacy were found to be the most significant factors predicting lower rates of unfinished nursing care. Refinement of factors in the nursing work environment and staffing are interventions that can mitigate unfinished nursing care. Further research should focus on the relationship between different dimensions of the nursing work environment and unfinished nursing care in hospital settings.