Background: A strong patient safety culture (PSC) may be associated with improved patient outcomes in hospitals. The mechanism that explains this relationship is underexplored; missed nursing care may be an important link.
Purpose: The purpose of this study was to describe relationships among PSC, missed nursing care, and 4 types of adverse patient events.
Methods: This cross-sectional study employed primary survey data from 311 nurses from 29 units in 5 hospitals and secondary adverse event data from those same units. Analyses include analysis of variance and regression models.
Results: Missed nursing care was reported to occur at an occasional level (M = 3.44, SD = 0.24) across all 29 units. The PSC dimensions explained up to 30% of the variance in missed nursing care, 26% of quality of care concerns, and 15% of vascular access device events. Missed care was associated with falls (P < .05).
Conclusions: Prioritized actions to enhance PSC should be taken to reduce missed nursing care and adverse patient outcomes.