Associations of Interprofessional Adaptive Coordination and Intercultural Communication Competence with Missed Nursing Care in Remote Hospitals in South Papua, Indonesia
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Missed nursing care remains a major patient safety concern, particularly in geographically isolated and culturally diverse healthcare systems where workforce shortages, communication barriers, and resource constraints challenge the continuity of care. Despite growing attention to nursing resilience and patient safety, limited evidence exists regarding how adaptive teamwork and intercultural communication contribute to reducing missed nursing care in remote multicultural healthcare settings. This study examined the roles of Risk Pattern Recognition, Safety Sensemaking, and Learning from Events Orientation in shaping Nurse Moral Resilience and Interprofessional Adaptive Coordination and their implications for Missed Nursing Care in South Papua, Indonesia. Method: A cross-sectional survey was conducted among 312 nurses working in frontline clinical units across four hospitals in Merauke Regency, South Papua. Data were analyzed using Partial Least Squares Structural Equation Modeling (PLS-SEM) and Importance–Performance Map Analysis (IPMA). Results: Risk Pattern Recognition, Safety Sensemaking, and Learning from Events Orientation significantly enhanced Nurse Moral Resilience. Risk Pattern Recognition, Safety Sensemaking, and Nurse Moral Resilience also significantly improved Interprofessional Adaptive Coordination. Interprofessional Adaptive Coordination was associated with lower levels of Missed Nursing Care, whereas Nurse Moral Resilience showed no direct relationship with Missed Nursing Care. Furthermore, Intercultural Communication Competence strengthened the protective effect of Interprofessional Adaptive Coordination on Missed Nursing Care, indicating that culturally responsive communication enhances the effectiveness of adaptive teamwork in multicultural healthcare environments. Conclusion: The findings suggest that reducing missed nursing care in remote multicultural hospitals depends more on adaptive interprofessional coordination and intercultural communication than on individual resilience alone. By integrating cognitive safety capabilities, moral resilience, and adaptive teamwork within a sensemaking framework, this study extends current patient safety literature and provides practical guidance for strengthening nursing care quality in underserved and culturally diverse healthcare systems.
Source: Healthcare
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,258
Funder: Universitas Pelita Harapan
OpenAlex ID: W7172530464