Team collaboration and caring ability as reciprocal predictors of missed nursing care: A cross-sectional study among emergency nurses in China

BACKGROUND: Missed nursing care remains a major patient safety concern in emergency departments, where high workloads and limited staffing frequently lead to omissions in fundamental care. Yet the impact of nurses' caring ability and team collaboration on missed care has received limited empirical attention. AIM: To examine the independent and interactive effects of nurses' caring ability and team collaboration on missed nursing care in emergency departments, and to assess potential bidirectional mediation mechanisms. METHOD: A cross-sectional study was conducted among 643 emergency nurses in five tertiary hospitals in Guangdong Province, China. Participants completed the Missed Nursing Care Scale, the Nursing Teamwork Survey, and the Caring Ability Inventory. Data were analysed using descriptive statistics, Pearson's correlation, multiple linear regression, and structural equation modelling. RESULTS: Both nurses' caring ability and team collaboration were significantly associated with reduced missed nursing care. Trust, support, courage, and cognition were identified as protective factors. Mediation modelling revealed a bidirectional mechanism in which each factor partially mediated the effect of the other on missed care. CONCLUSION: This study highlights the reciprocal relationship between interpersonal competencies and missed nursing care. Interventions targeting both individual and team-level capacities may enhance care quality and patient safety in high-intensity emergency settings.