From talk to action: A randomized controlled design on the role of huddles in shaping safety climate and reducing missed nursing care

IF 2.2 4区医学 Q1 NURSING

Applied Nursing Research Pub Date : 2026-08-01 Epub Date: 2026-07-17 DOI:10.1016/j.apnr.2026.152117

Marina Vexler, Anat Drach-Zahavy, Einav Srulovici

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引用次数: 0

Abstract

Background

Missed nursing care compromises patient safety and care quality worldwide. Although inadequate staffing, high workloads, and poor work environments contribute, brief structured team interventions may reduce care omissions. Proactive huddles aim to enhance communication, coordination, and early risk identification, yet the mediating role of safety climate remains unclear.

Objective

To evaluate the effectiveness of proactive huddles in reducing missed nursing care and examine the mediating role of safety climate.

Design

Randomized controlled design.

Methods

Data were collected between July 2022 and May 2023 from ten hospital wards, pair-matched by type and size and randomly assigned to proactive huddles or usual practice. The sample comprised 180 nurses (85 intervention, 95 control). The MISSCARE Survey, Safety Organizing Scale, and NASA Task Load Index were administered pre- and post-intervention across three shifts. Linear mixed-effects models and moderated mediation analysis were conducted.

Results

Proactive huddles were associated with improved safety climate compared with usual practice (b = −0.217, p < .001) and with reduced missed nursing care (b = 0.123, p < .001). Higher safety climate was associated with lower missed nursing care (b = −0.184, p < .001). Moderated mediation indicated a greater mediated reduction in missed nursing care via safety climate in the intervention group (difference in average causal mediation effect = −0.038; 95% CI [−0.059, −0.018]; p < .0001).

Conclusion

Proactive huddles may offer a feasible, time-efficient strategy for reducing missed nursing care. Safety climate may be one mechanism linking structured communication with improved care quality, alongside other team-level mechanisms.

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从谈话到行动：关于会议在塑造安全气候和减少护理遗漏方面的作用的随机对照设计

背景：全球范围内，护理遗漏危及患者安全和护理质量。虽然人员配备不足、工作量大和工作环境差是造成这种情况的原因，但简短的结构化团队干预可能会减少护理疏漏。主动会议旨在加强沟通、协调和早期风险识别，但安全气候的中介作用尚不清楚。目的评价主动会议减少护理疏漏的效果，探讨安全氛围的中介作用。随机对照设计。方法于2022年7月至2023年5月期间从10个医院病房收集数据，按类型和规模配对，随机分配到主动分组或常规分组。样本共180名护士（干预组85名，对照组95名）。MISSCARE调查、安全组织量表和NASA任务负荷指数在干预前和干预后进行了三个班次的管理。进行了线性混合效应模型和有调节的中介分析。结果与常规做法相比，主动会议改善了安全气氛（b = - 0.217, p < .001），减少了护理遗漏（b = 0.123, p < 001）。较高的安全氛围与较低的护理遗漏相关（b = - 0.184, p < .001）。有调节的中介表明，干预组通过安全气候介导的错过护理的减少更大（平均因果中介效应差异= - 0.038;95% CI [- 0.059, - 0.018]; p < 0.0001）。结论主动会议为减少护理遗漏提供了一种可行、省时的策略。与其他团队层面的机制一样，安全氛围可能是将结构化沟通与提高护理质量联系起来的一种机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Applied Nursing Research 医学-护理

CiteScore

4.50

自引率

0.00%

发文量

审稿时长

70 days

期刊介绍： Applied Nursing Research presents original, peer-reviewed research findings clearly and directly for clinical applications in all nursing specialties. Regular features include "Ask the Experts," research briefs, clinical methods, book reviews, news and announcements, and an editorial section. Applied Nursing Research covers such areas as pain management, patient education, discharge planning, nursing diagnosis, job stress in nursing, nursing influence on length of hospital stay, and nurse/physician collaboration.