The Work Behind the Work: Logistical-Administrative Workload, Health Technology Satisfaction and Missed Nursing Care Among Belgian Hospital Nurses.

BACKGROUND: Hospital nurses face increasing logistical-administrative demands and the widespread use of digital systems. Both may affect job satisfaction and patient safety by increasing workload and contributing to missed nursing care. OBJECTIVE: To quantify logistical-administrative workload and satisfaction with health technology among hospital nurses and to identify associations with job satisfaction and the prevalence of missed care. DESIGN: Cross-sectional survey. SETTING(S): A national cross-sectional survey of all nurses working in hospitals in Belgium was conducted between September 16 and October 18, 2024. PARTICIPANTS: A total of 3613 hospital nurses (79% staff nurses and 21% nurse managers) completed the entire online survey. METHODS: An online questionnaire assessed the proportion of time spent on administrative and logistical tasks, satisfaction with health technologies, job satisfaction, and 15 types of missed nursing care. Multivariable logistic and Poisson regression models, adjusted for sociodemographic and work environment factors, were applied. RESULTS: Nurses reported spending a median of 18% per shift on logistical-administrative tasks, with staff nurses spending more time than nurse managers (20% vs. 10%, p < 0.001) on these tasks. Overall, 71.7% were satisfied with their job, yet 72.1% reported at least one missed care activity. Higher logistical-administrative workload was associated with greater odds of job dissatisfaction (ORa = 1.15, 95% CI [1.10-1.20]) and more missed care (IRRa = 1.12 [1.04-1.20]). Dissatisfaction with health technologies was similarly linked to job dissatisfaction (ORa = 1.30 [1.07-1.58]) and missed care (IRRa = 1.17 [1.10-1.24]). Poor or average work environment was strongly associated with job dissatisfaction (ORa = 15.51 [12.04-19.71]) and missed care (IRRa = 1.36 [1.28-1.50]). CONCLUSIONS: Higher perceived logistical-administrative workload and lower satisfaction with health technologies were associated with increased job dissatisfaction and missed nursing care among hospital nurses. These findings highlight the importance of considering how administrative demands and digital tools are integrated into daily nursing work when addressing working conditions and care quality.