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Nurse and Nurse Assistant Perceptions of Missed Nursing Care: What Does It Tell Us About Teamwork?

Kalisch, Beatrice J. PhD

JONA: The Journal of Nursing Administration: November 2009 - Volume 39 - Issue 11 - p 485-493
doi: 10.1097/NNA.0b013e3181bd61ac

Missed nursing care is a pervasive problem in acute care hospitals as is dysfunctional nursing teamwork. Given that teamwork has a significant impact on healthcare quality and patient safety, the author reports findings from a study that examined differences in perceptions between RNs and nursing assistants as to the extent of missed nursing care and the reasons for missing that care. Study findings point to a lack of essential elements of teamwork (ie, closed-looped communication, leadership, team orientation, trust, and shared mental models). The author analyzes what this reveals about teamwork between these 2 groups of nursing personnel who work side by side caring for the same patients and offers specific interventions.

Author Affiliation: Chair, Nursing Business and Health Systems, Titus Professor, University of Michigan, Ann Arbor, Michigan.

Correspondence: University of Michigan School of Nursing, 400 N Ingalls St, Ann Arbor, MI 48109 (

Funding: This study was funded by the Michigan Center for Health Intervention, University of Michigan School of Nursing, National Institutes of Health-National Institute for Nursing Research (P30 NR009000) and by the Blue Cross Blue Shield Foundation of Michigan.

© 2009 Lippincott Williams & Wilkins, Inc.