The personality profile of the accountable nurse and missed nursing care

Aim: The aim of this study was to examine the mediating role of nurses’ personal accountability in the relationships between nurse's personality and missed nursing care. Background: Personal accountability is considered as a core value in nursing, shaped by the nurse's personality, education, socialization into the profession and experience. Personality antecedents may be uniquely suited to predicting accountability, since it reflects variation in individuals’ deep-seated values and beliefs. Personal accountability can be related to the prevalent phenomenon of missed nursing care (tasks that are omitted or delayed). Design: A multicentre cross-sectional study with 290 nurses from direct-care nursing wards during 2017. Personality traits were assessed with the 44-item Big Five Inventory. Personal accountability was assessed with a 19-item scale. Missed nursing care was assessed with the 22-item MISSCARE survey. An indirect mediated path analysis was performed and compared with an alternative model with direct effects. Results: Path-analyses findings supported a full-mediation model of accountability in the relationships between personality traits and missed nursing care. Conscientiousness, Agreeableness, Openness and Neuroticism, but not Extraversion, were significantly related to personal accountability. In addition, greater personal accountability was significantly related to lower frequency of missed nursing care. Conclusions: Personal traits are important antecedents of personal accountability, which relates to missed nursing care. Findings delineate the profile of the accountable nurse and might help in developing strategies for the selection of nurses with high personal accountability and determining the best means to strengthen accountable behaviours in the workplace.