# The Impact of Workflow Interruptions, Work Readiness, and Missed Nursing Care on Patient Safety Competency Among New Nurses: A Multicenter Longitudinal Study

## TL;DR

This study finds that workflow interruptions reduce new nurses' patient safety skills by affecting their readiness and causing missed care.

## Contribution

The study identifies a chain mediation mechanism linking workflow interruptions to patient safety competency through work readiness and missed nursing care.

## Key findings

- Workflow interruptions were strongly negatively linked to patient safety competency and work readiness.
- Workflow interruptions increased missed nursing care, which mediated the impact on safety competency.
- Work readiness and missed nursing care together explained 12.61% of the total effect of interruptions on safety competency.

## Abstract

Patient safety competency is a critical attribute for new nurses. However, limited research has investigated the influencing factors and mechanisms affecting new nurses’ safety competency, indicating the need for further exploration.

This study aimed to examine the impact of workflow interruptions on new nurses’ patient safety competency and to explore the mediating roles of work readiness and missed nursing care using a longitudinal design.

From March to September 2024, a three‐wave longitudinal study was conducted among 793 new nurses across 14 hospitals in China using a multicenter, stratified cluster sampling method. A total of 706 valid responses were included. Data collected covered demographic information, workflow interruptions, patient safety competency, work readiness, and missed nursing care. SPSS 27.0 was used for data analysis, and Amos 24.0 was applied to construct a structural equation model to assess the effects and mediation mechanisms.

Workflow interruptions were significantly negatively correlated with patient safety competency (r = −0.381, p < 0.01) and work readiness (r = −0.311, p < 0.01) and positively correlated with missed nursing care (r = 0.375, p < 0.01). Work readiness and missed nursing care acted as sequential mediators in the relationship between workflow interruptions and patient safety competency, accounting for 12.61% of the total effect.

Work readiness and missed nursing care play a chain mediating role between workflow interruptions and new nurses’ patient safety competency. Future interventions should aim to optimize workflow processes, minimize unnecessary interruptions, and enhance new nurses’ training and psychological support to improve their ability to function in complex clinical environments, thereby ensuring care quality and patient safety.