Nursing care left undone, practice environment and perceived quality of care in small rural hospitals.

AIM: To examine nursing care left undone and its relationship with the nursing practice environment and perceived quality of nursing care in small Australian rural hospitals.
BACKGROUND: Nurses in small rural hospitals often work with few resources, limited backup and staff shortages. The relationship between this rural practice environment and care left undone has not been fully explored.
METHOD: A descriptive cross-sectional survey.
RESULTS: Over half participants (n = 241, 62.9%) reported having left some activities undone on their most recent shift. There were moderately significant correlations between care left undone and nursing practice environment and overall quality of care. Nurses who reported leaving care left undone had statistically significant lower perceptions of the nursing practice environment than those who had no care left undone.
CONCLUSION: Nursing care activities are being left undone in rural hospitals. Both care left undone and quality of nursing care may be affected by the nursing practice environment. IMPLICATIONS FOR NURSING MANAGEMENT: To maximize care quality, rural hospital managers must consider the prevalence of care left undone and may use this information as a predictor of both patient outcomes and staffing and resource requirements. Given the challenges of rural hospitals, rural nurse managers can use this evidence to support their requests for increased staffing and resources.