ArticleJournal of clinical nursing2025
The dual protective role of accountability: Mitigating missed nursing care and nurse moral distress in a nested diary study design.
Article in Journal of clinical nursing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed.
- Portuguese Version of the MISSCARE Survey-Patient: A Cross-Cultural Validation Study.Nursing reports (Pavia, Italy) · 2026Article
- Emotions in Nursing Care Prioritisation Decisions: A Critical Incident Debriefing Study of Missed Nursing Care.Journal of advanced nursing · 2026Article
- Understanding missed nursing care through felt accountability focus and task complexity: A prospective repeated-measures field study.International journal of nursing studies advances · 2026Article
- Juxtaposing Nurses' and Patients' Perspectives of Missed Nursing Care: A Descriptive Mixed Method Design.Journal of advanced nursing · 2025Article
- The dual protective role of accountability: Mitigating missed nursing care and nurse moral distress in a nested diary study design.Journal of clinical nursing · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
aimsTo examine a novel moderated-mediation model, investigating whether personal accountability moderates the link between nurse workload and missed nursing care and whether missed nursing care mediates the association between workload and moral distress.
designNested diary study.
methodsData spanning from February 2019 to February 2023 were collected from 137 nurses working in various inpatient wards in two medium-sized hospitals. Nurses reported care given to specific patients on three to five occasions across different shifts, establishing nurse-patient dyads. Validated measures of missed nursing care, personal accountability, moral distress and workload were analyzed using mixed linear models to test the nested moderated-mediation model.
resultsUnder high workload conditions, nurses with higher personal accountability reported lower frequencies of missed nursing care compared to those with lower personal accountability. In contrast, under low workload conditions, personal accountability did not significantly influence missed nursing care occurrences. Furthermore, the interaction between workload and personal accountability indirectly affected nurses' moral distress through missed nursing care. Specifically, higher personal accountability combined with lower missed nursing care contributed to reduced levels of moral distress among nurses.
conclusionThe study highlights accountability's dual role-safeguarding against care omissions and influencing nurses' moral distress amid rising workload pressures. IMPLICATION FOR THE PROFESSION AND/OR PATIENT CARE: Cultivating a culture of accountability within healthcare settings can serve as a protective factor against the negative effects of workload on patient care quality and nurse psychological distress, highlighting the need for organizational interventions to promote accountability among nursing staff. IMPACT: By recognizing accountability's pivotal role, organizations can implement targeted interventions fostering accountability among nurses, including training programs focused on enhancing responsibility/ownership in care delivery and creating supportive environments prioritizing accountability to achieve positive patient outcomes. REPORTING
methodThe study has adhered to STROBE guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.