Teamwork, clinical leadership skills and environmental factors that influence missed nursing care – A qualitative study on hospital wards

To explore how nursing teams in clinical inpatient nursing hospital wards perform teamwork to prevent or reduce missed nursing care and how teamwork is influenced by clinical leadership skills and environmental factors.Earlier studies on missed nursing care identified teamwork and leadership skills as promising factors in inpatient care that can positively influence quality of care and reduce missed nursing care. The effective use of teamwork in hospitals requires understanding what it is, how it is performed by nursing teams and how it is influenced by clinical leadership skills and environmental factors.A qualitative exploratory study was undertaken between January and March 2021.A total of 16 registered nurses who worked on various hospital wards, participated in three online focus groups. Data were analyzed with thematic analysis according to Braun and Clarke.Thematic analysis revealed four themes. First, nurses perform teamwork and clinical leadership skills in various ways. Some nurses work in pairs and have common goals, while other nurses work individually. This influences teamwork. Second, nurses are informal teachers, visible in teaching and learning from each other, contributing in constructive teamwork. Third, senior nurses are seen as informal leaders, forming connection between nursing wards and formal leaders, resulting in awareness of each other and the progress of patientcare. Finally, environmental factors influence the performance of teamwork.Results of this study show how knowledge regarding missed nursing care can be increased. Results can be used for developing training programs and embedding education in practice aimed at constructive teamwork, clinical leadership skills and missed nursing care.