MISSCARE Survey Research Articles

Presenteeism and missed nursing care: a descriptive, correlational and observational study

BackgroundMissed nursing care poses a significant challenge for healthcare staff in terms of patient safety and care quality.ObjectiveTo evaluate presenteeism and missed care attitudes of nurses and to determine the correlation between presenteeism and missed care.MethodsThis descriptive, correlational, and observational study was conducted between February and August 2023. The Stanford Presenteeism Scale-Short Form and the MISSCARE Survey were used to collect the data among nurses at two public hospitals in a city in Turkey. The study was completed with 229 nurses representing 27.4% of the total number of nurses who met the inclusion criteria. The data was analyzed using a comprehensive analytical approach, including Cronbach’s alpha analysis, frequency and percentage distribution, the Shapiro–Wilk test of normality, correlation coefficient analysis, Pearson correlation coefficient, and the Bonferroni test.ResultsThe participants’ mean age was 30.22 ± 7.14 years, and 74.2% of them were female. 53.3% of the participants reported difficulty providing patient care due to material shortages, and 62.9% experienced challenges delivering care due to the intensity of paperwork in the clinic. Nurses who felt that paperwork intensity affected patient care and were not confident in their care provision had higher levels of presenteeism (p = 0.041) and a significantly higher frequency of missed care instances (p < 0.001).ConclusionsMaterial shortages and high paperwork intensity are contributing factors to the difficulties experienced by nurses in their practice. These difficulties may lead to an increase in presenteeism and instances of missed nursing care. It is important to address these challenges to ensure adequate care provision and reduce the likelihood of presenteeism among nurses. The correlation between presenteeism and instances of missed nursing care highlights the impact of presenteeism behaviors on the quality of patient care.

Missed nursing care in surgical care– a hazard to patient safety: a quantitative study within the inCHARGE programme

BackgroundMissed nursing care occurs globally, and the consequences are severe for the patients when fundamental care needs are not fulfilled, nor delivered in a person-centred way. This study aimed to investigate the occurrence and cause of missed nursing care, and the relationship between registered nurses’ and nursing assistants’ perceptions of missed nursing care, in a surgical care context.MethodsA quantitative study was performed using the MISSCARE survey, measuring missed nursing care and associated reasons, in three surgical wards with registered nurses and nursing assistants as the participants (n = 118), during May-November in 2022. The MISSCARE survey also covers background data such as job satisfaction and intention to leave. The survey was distributed paper-based and the response rate was 88%.ResultsAspects of nursing care rated to be missed the most were ‘attending interdisciplinary care conferences’, ‘turning patient every 2 h’, ‘ambulation 3 times per day or as ordered’, and ‘mouth care’. Differences between registered nurse and nursing assistant ratings were detected for eight out of 24 items, where registered nurses rated more missed nursing care. The uppermost reasons for missed nursing care were ‘inadequate number of staff’ and ‘unexpected rise in patient volume and/or acuity on the unit’. Registered nurses and nursing assistants rated differently regarding six of 17 items. Almost every fourth staff member (24.6%, n = 29) had the intention to leave within a year in the present department.ConclusionsThe occurrence of missed nursing care is frequent in the surgical context, and in combination with a high number of staff members intending to leave their employment, poses a hazard to patient safety. Registered nurses, holding higher educational levels, reported more missed care compared with the nursing assistants. The main reason for missed nursing care was an inadequate number of staff. These findings support a warranted investment in nursing within the organisation. The results can be used to form strategies and interventions, to reduce nurse attrition and optimise competence utilisation, and to achieve safe person-centered fundamental care.

Factors associated with the quality of dying and death and missed nursing care.

Patients in intensive care units need full nursing care due to the high mortality rate. However, some aspects of nursing care can be forgotten. To investigate the quality of death and dying and its association with aspects of missed nursing care, alongside the overall perception of nurses in intensive care units about factors associated with missed nursing care. This cross-sectional study used a census sampling method of 105 nurses working in intensive care units. In order to collect data, the Quality of Dying and Death Questionnaire (QODD), missed nursing care (MISSCARE survey) and factors associated with missed nursing care questionnaire were used. Data analysis was performed by using SPSS 16. The quality of death and dying, as perceived by nurses, was found to be lower than the average (Range score: 0 to 100). The range of missed nursing care was average (Range of score: 24 to 96) and the most noticeable reason for this missed nursing care was the shortage of nursing staff. Managers should ensure that nurses provide complete nursing care for terminally ill patients in intensive care units and eliminate factors that lead to aspects of nursing care being missed, such as staffing levels, material resources and communication between staff members.

Unfinished nursing care in healthcare settings during the COVID-19 pandemic: a systematic review

BackgroundUnfinished nursing care is becoming increasingly more of a concern in worldwide healthcare settings. Given their negative outcomes, it is crucial to continuously assess those nursing interventions that are commonly postponed or missed, as well as the underlying reasons and consequences. The worldwide COVID-19 pandemic has made it difficult for health facilities to maintain their sustainability and continuity of care, which has also influenced the unfinished nursing care phenomenon. However, no summary of the studies conducted during the COVID-19 pandemic was produced up to now. The main aim of this study was to systematically review the occurrence of, reasons for, and consequences of unfinished nursing care among patients in healthcare settings during the COVID-19 pandemic.MethodsSystematic review registered in PROSPERO (CRD42023422871). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guideline and the Joanna Briggs Institute Critical Appraisal tool for cross-sectional studies were used. MEDLINE-PubMed, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were searched from March 2020 up to May 2023, using keywords established in the field as missed care, unfinished nursing care, or implicit rationing.ResultsTwenty-five studies conducted mainly in European and Asiatic countries were included and assessed as possessing good methodological quality. The following tools were used: the MISSCARE Survey (= 14); the Basel Extent of Rationing of Nursing Care (= 1), also in its revised form (= 2) and regarding nursing homes (= 2); the Perceived Implicit Rationing of Nursing Care (= 4); the Intensive Care Unit-Omitted Nursing Care (= 1); and the Unfinished Nursing Care Survey (= 1). The order of unfinished nursing care interventions that emerged across studies for some countries is substantially in line with pre-pandemic data (e.g., oral care, ambulation). However, some interesting variations emerged at the country and inter-country levels. Conversely, labour resources and reasons close to the emotional state and well-being of nurses were mentioned homogeneously as most affecting unfinished nursing care during the pandemic. None of the studies investigated the consequences of unfinished nursing care.ConclusionsTwo continents led the research in this field during the pandemic: Europe, where this research was already well established, and Asia, where this research is substantially new. While unfinished care occurrence seems to be based on pre-established patterns across Europe (e.g., regarding fundamentals needs), new patterns emerged across Asiatic countries. Among the reasons, homogeneity in the findings emerged all in line with those documented in the pre-pandemic era.

The influence of selected work characteristics on missed and unfinished nursing care in hospitals: Evidence from the Czech Republic

Missed and unfinished nursing care in hospitals depends on the quality of human resources. This paper aims to analyze the influence of selected work characteristics on missing and incomplete nursing care in inpatient wards of Czech hospitals. The relationship between the rate of missed and unfinished nursing care and selected work characteristics was studied using the Czech version of the standardized questionnaire, the MISSCARE Survey. The study was conducted from September 26, 2021, to October 15, 2021. Controlled interviews with 1,205 nurses working in ward blocks in Czech hospitals were used. The research results showed statistically significant connections between selected work characteristics and missed and unfinished nursing care. Nurses with the highest level of education (Master, Ph.D.), nurses with specialized education, nurses with the lowest number of working hours (less than 30 hours per week), and nurses with the highest number of years of work experience (21 years and over) show a significantly lower rate of missed nursing care. Nurses from surgical departments, specialist nurses, and nurses with the highest education (Master, Ph.D.) report statistically significantly lower unfinished care levels. In contrast, nurses from regional/district hospitals, practical nurses/nursing assistants, and nurses with the lowest education (secondary school of nursing) report significantly higher unfinished nursing care levels. The information obtained can be used to improve nursing processes in the identified weak parts, strategic planning of nursing care, and sufficient personnel. AcknowledgmentsI would like to express my gratitude to co-authors and other members of the research team – Hana Hajduchová, Chloubová Ivana, Hana Kubešová, Josef Malý, Martin Doseděl, Ondřej Tesař, and Kateřina Malá-Ládová, without whose support the article could not have been published.Supported by the Ministry of Health of the Czech Republic, grant no. NU20-09-00257. All rights reserved.

Frontline Nurses’ Job Satisfaction and Missed Nursing Care in a COVID-19 Dedicated Hospital in China: A Cross-Sectional Study

This study examined the current situation and relationship between missed nursing care (MNC) and job satisfaction among frontline nurses in a hospital dedicated to treating COVID-19 patients in China. Many dedicated hospitals were constructed or refurbished to centrally manage patients with COVID-19. Most nurses and doctors in these hospitals were redeployed from other departments or hospitals. This may have compromised nursing quality and job satisfaction. The omission of nursing care is a critical factor in assessing nursing quality; therefore, focusing on both MNC and job satisfaction is essential. This cross-sectional study used convenience and snowball sampling techniques to recruit frontline nurses working in a hospital for treating COVID-19 patients from November to December 2022. The questionnaires used in this study included sociodemographic information, job satisfaction, and the MISSCARE survey. Differences in job satisfaction and MISSCARE scores among participants’ demographic deviations were explored using the Mann–Whitney Z test (two groups) and the Kruskal–Wallis H test (three or more groups). The correlation between participants’ job satisfaction and missed nursing actions was analysed using Spearman’s correlation analysis. The analysis included 306 frontline nurses. Frontline nurses’ job satisfaction was high, and their MNC was low. The highest MNC was “offer rehabilitation care and guidance to patients in need every day.” The most reported reasons for the MNC were “urgent patient situations.” In addition, the job satisfaction scale, MNC scores, and reasons for MNC scores showed statistically significant differences among participants’ demographic variables. Moreover, this study identified a negative correlation between frontline nurses’ job satisfaction and MNC. Frontline nurses’ job satisfaction was high, and their MNC was low. Frontline nurses’ demographics were shown to affect their job satisfaction, MNC, and reported reasons. Furthermore, participants’ job satisfaction can influence the MNC. Tailored interventions aimed at maintaining low levels of MNC should consider frontline nurses’ demographic characteristics and job satisfaction.

The frequency and reasons for missed nursing care in Australian perioperative nurses: A national survey.

To describe Australian perioperative nurses' reported frequency and reasons for missed nursing care in the operating room. Cross-sectional online survey conducted in March-April 2022. A census of Australian perioperative nurses who were members of a national professional body were invited to complete a survey that focussed on their reported frequency of missed nursing care and the reasons for missed nursing care in the operating room using the MISSCare Survey OR. In all, 612 perioperative nurses completed the survey. The perioperative and intraoperative nursing care tasks reported as most frequently missed included time-intensive tasks and communication with multiple surgical team members present. The most frequently reported reasons for missed care were staffing-related (e.g. staff number, skill mix, fatigue and complacency) and affected teamwork. There were no significant differences in the frequency of missed care based on perioperative nurse roles. However, there were statistically significant differences between nurse management, circulating/instrument nurses and recovery room nurses in reasons for missed care. Much of the missed care that occurs in the operating room is related to communication practices and processes, which has implications for patient safety. Understanding the types of nursing care tasks being missed and the reasons for this missed care in the operating room may offer nurse managers deeper insights into potential strategies to address this situation. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement. No patient or public contribution.

Structural Equation Modeling of Associations Between Nursing Practice Environment And Missed Nursing Care: A Cross-sectional Study.

Missed nursing care (MNC) negatively impacts the quality of patient care. There may be a relationship between the nursing practice environment (NPE) and MNC; however, this relationship has not been examined in developing countries during the COVID-19 pandemic. To determine the relationship between the NPE and MNC during the COVID-19 pandemic. A cross-sectional study of 300 participants was conducted in 4 teaching hospitals in Iran. Data were collected using a demographic and clinical form, the Nursing Professional Practice Environment Questionnaire, and MISSCARE survey and analyzed using structural equation modeling. The hypothesized model was well fit, showing that 1 unit improvement of the NPE domains of patient-centered care , effective leadership , and policy transparency decreased MNC by 0.18, 0.12, and 0.05, respectively. The model confirmed the association between the dimensions of the NPE and MNC. These findings can assist health policymakers and nursing managers in improving the NPE.

The holistic nursing competence and transition shock of newly graduated nurses as the determinants of missed nursing care: The mediation analysis.

To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care. Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence. Descriptive and correlational design. The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1-12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist. The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care. Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses. The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education.

Translation and psychometric testing of the Chinese version of the Perinatal Missed Care Survey

ObjectiveThis study aimed to translate and evaluate the psychometric properties of the Perinatal Missed Care Survey in China. MethodsThe Perinatal Missed Care Survey was translated according to the guidelines of the cross-cultural debugging scale recommended by the American Academy of Orthopaedic Surgeons Evidence-Based Medicine Committee, including forward translation, back translation, cultural adaption, and content validation, and its Chinese version was used in a cross-sectional study conducted from February to April in 2023. A total of 491 midwives from 14 different level hospitals in southwest China were recruited through a convenience sampling method. The discrimination ability of the items was tested through item analysis, and construct validity was assessed through exploratory factory and confirmatory factor analyses. The content validity index and Cronbach’s α coefficients evaluated content validity and reliability, respectively. ResultsThe Chinese version’s item–total correlation coefficients ranged from 0.641 to 0.866 in part A and from 0.644 to 0.819 in part B (P < 0.001). Parts A and B’s scale-level content validity indexes were 0.95, and the item-level content validity indexes were from 0.86 to 1.00. The three common factors of part A (necessary care, basic care, and postnatal care) and part B (communication, labor resources, and material resources) were extracted, accounting for 70.186% and 71.984% of the total variance, respectively. Confirmatory factor analysis indicated that the good fit of the three-factor models was acceptable. The Cronbach’s α coefficients were 0.968 (part A) and 0.940 (part B). ConclusionThe Chinese version of the Perinatal Missed Care Survey is a reliable and valid instrument for assessing nursing care missed by midwives during labor and birth and the reasons it was missed. Studies with large sample sizes are needed to verify the instrument’s applicability in China.

The Relationship between Nursing Job Satisfaction and Missed Nursing Care in Critical Care Units

Background: Missed nursing care is a common occurrence that has a negative impact on the standard of patient care. Missed care is indicative of nurses' affected work satisfaction in times of workflow. The purpose of this study was to determine the prevalence of missed nursing care (MNC), and the reasons for its occurrence among Jordanian nurses. The study sought to assess the level of job satisfaction and missed nursing care among Jordanian nurses and their association with demographic variables. Methods: A descriptive, cross-sectional design was used in this study. A convenience sample of 181 registered nurses working in different critical care units in one teaching hospital and two government hospitals was recruited. Three tools were used to collect the data: a sociodemographic data form, a survey of missed nursing care (MISSCARE Survey) consisting of two parts (part A was designed to measure missed nursing care (MNC), and part B addressed the reasons for MNC), and the nursing-workplace satisfaction questionnaire (NWSQ). Results: The results of the study revealed Jordanian nurses in critical care units to have a moderate level of job satisfaction (45.50±9.09). In addition, the total mean score of the MNC was found to be 2.18±0.40 out of 5, which is a low level of missed nursing care. The most commonly occurring missed nursing care aspects were turning patients every 2 hours (2.53 ±1.43), mouth care (2.37 ±1.36), and teaching patients about illness, tests, and diagnostic studies (2.36 ±1.47). Moreover, among the reasons for missed nursing care with respect to teamwork, the caregiver being off the unit or unavailable was the most significant one (24.3%, n=44); with respect to the material resources, the unavailability of medications, when needed, was the most significant factor (21.5%, n=39) for missed nursing care, and regarding the labor resources, an unexpected rise in patient volume and acuity on the unit was the most significant factor influencing missed nursing care (23.8%, n=43). Finally, a statistically significant weak negative correlation was found between nurses’ job satisfaction and missed nursing care score (R=-0.177, P=0.012). Conclusion: The study concluded that nurses in critical units have a low level of missed nursing care and a moderate level of job satisfaction.

The relationship between nurse burnout, missed nursing care, and care quality following COVID-19 pandemic.

To determine the relationship between nurse burnout, missed nursing care, and care quality following the COVID-19 pandemic. Quality of care and missed nursing care can be consequences of nurse burnout. Little is known about how these factors related to nurse burnout following the COVID-19 pandemic. This study used a cross-sectional correlational design and was conducted in 12 general hospitals across Thailand from August to October 2022. 394 nurses providing direct nursing care to patients during the COVID-19 pandemic completed the survey. The Emotional Exhaustion (EE) subscale of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), MISSCARE survey, and quality of care reported by nurses were used to collect data. Descriptive statistics and logistic regression models were used to analyse the data. Approximately thirty-six percent of nurses had burnout following the COVID-19 pandemic. Missed nursing care was higher among nurses with burnout. Most participants reported illness/symptoms such as anxiety, fatigue, a lack of concentration, and sleeping problems. After adjusting for demographic characteristics, every additional unit of emotional exhaustion was associated with 1.61 times higher odds of missed nursing care, 3.37 times higher odds of poor quality of nurse care, and 2.62 times higher odds of poor quality of care for the overall unit. The study findings demonstrate that burnout is associated with missed nursing care and poor quality of care following the COVID-19 pandemic. Policymakers, hospital administrators, and nurse managers should invest in strategies to reduce nurse burnout, which can increase patient safety and quality of care.

Inadequate number of staff and other reasons for implicit rationing of nursing care across hospital types and units.

The aim of the study was to find differences in perceived reasons for implicit rationing of nursing care across hospital types and units. A descriptive multicentre study. The study in 14 Czech acute care hospitals was conducted from September 2019 to October 2020. The sample consisted of 8316 nurses working in medical and surgical units. Items for rating the reasons for implicit rationing of nursing care were selected from the MISSCARE Survey. Nurses were asked to rate each item on a scale from 0 (a not significant reason) to 10 (the most significant reason). The most significant reasons for implicit rationing of nursing care were 'Inadequate number of staff', 'Inadequate number of assistive personnel' and 'Unexpected patient admission and discharge'. Most reasons were rated as more significant by nurses from non-university hospitals. Nurses from medical units perceived all reasons for implicit rationing of nursing care as more significant.

Experience of missed nursing care: A mixed method study.

Missed nursing care is a global phenomenon affecting patient safety and quality of care. The working environment of nurses seems to play an important role in missed nursing care. This study was conceptualized to explore the link of environmental constraints with missed nursing care in the Indian context. A convergent mixed-method design was adopted, and data was collected using Kalisch's MISSCARE survey from 205 randomly selected nurses involved in direct patient care in the acute care settings of four tertiary care hospitals in India. In the qualitative phase, in-depth interviews regarding nurses' experience of missed care were performed with 12 nurses chosen by maximum variant sampling from the quantitative sample. The integrated results revealed that nurses experience a sense of competing priority in the environment where curative and prescribed tasks like medication administration get more priority than activities like communication, discharge teaching, oral hygiene, and emotional support, which are frequently missed. The human resource and communication constraints together explained 40.6% of variance in missed nursing care. Human resource inadequacy in times of increased workload was the most frequently cited reason for missed care. Converging with this finding, nurses in the interviews expressed that maintaining a flexible number of staff and catering to the variable workload can effectively reduce missed nursing care. Frequent interruption of nursing activities by medical staff and lack of structure in some activities were cited as important reasons for missed care. Nursing leaders need to acknowledge missed care in nursing and develop policies to maintain flexible staffing based on situational workload. Methods of staffing like NHPPD (Nursing hour per patient day) which are more sensitive to nursing workload, and patient turnover, can be adopted instead of a fixed nurse-patient mandate. Mutual support from team members and multi-professional cooperation can reduce frequent interruption of nursing tasks thereby reducing missed care.

Three Missed Critical Nursing Care Processes on Labor and Delivery Units During the COVID-19 Pandemic

ObjectiveTo examine the relationships of three missed critical nursing care processes on labor and delivery units with reduced nursing time at the bedside and adequacy of unit staffing during the COVID-19 pandemic in the United States. DesignA cross-sectional survey. SettingOnline distribution from January 14 to February 26, 2021. ParticipantsA national convenience sample (N = 836) of registered nurses employed on labor and delivery units. MethodsWe conducted descriptive analyses on respondent characteristics and critical missed care items adapted from the Perinatal Missed Care Survey. We conducted robust logistic regression analyses to assess the relationships of three missed critical nursing care processes (surveillance of fetal well-being, excessive uterine activity, and development of new maternal complications) with reduced nursing time at the bedside and adequacy of unit staffing during the COVID-19 pandemic. ResultsLess nursing time at the bedside was associated with greater odds of missing any of the critical aspects of care, adjusted odds ratio = 1.77, 95% confidence interval [1.12, 2.80]. Adequate staffing greater than or equal to 75% of the time was associated with lower odds of missing any of the critical aspects of care compared to adequate staffing less than or equal to 50% of the time, adjusted odds ratio = 0.54, 95% confidence interval [0.36, 0.79]. ConclusionPerinatal outcomes are dependent on the timely recognition of and response to abnormal maternal and fetal conditions during childbirth. In times of unexpected complexity in care and resource constraints, a focus on three critical aspects of perinatal nursing care is needed to maintain patient safety. Strategies that enable bedside presence of nurses, including maintaining adequate unit staffing, may help to mitigate missed care.

Linking Patient Safety Climate With Missed Nursing Care in Labor and Delivery Units: Findings From the LaborRNs Survey.

This study aimed to explore the association of nurses' perceptions of patient safety climate with missed nursing care in labor and delivery (L&D) units. We recruited nurse respondents via email distribution of an electronic survey between February 2018 and July 2019. Hospitals with L&D units were recruited from states with projected availability of 2018 state inpatient data in the United States. Measures included the Safety Attitudes Questionnaire Safety Climate Subscale and the Perinatal Missed Care Survey. We estimated the relationship between safety climate and missed care using Kruskal-Wallis tests and mixed-effects linear regression. The analytic sample included 3429 L&D registered nurses from 253 hospitals (response rate, 35%). A majority of respondents (65.7%) reported a perception of good safety climate in their units, with a mean score of 4.12 (±0.73) out of 5. The mean number of aspects of care occasionally, frequently, or always missed on respondents' units was 11.04 (±6.99) out of 25. χ2 Tests showed that six mostly commonly missed aspects of care (e.g., timely documentation) and three reasons for missed care (communications, material resources, and labor resources) were associated with safety climate groups ( P < 0.001). The adjusted mixed-effects model identified a significant association between better nurse-perceived safety climate and less missed care ( β = -2.65; 95% confidence interval, -2.97 to -2.34; P < 0.001) after controlling for years of experience and highest nursing education. Our findings suggest that improving safety climate-for example, through better teamwork and communication-may improve nursing care quality during labor and birth through decreasing missed nursing care. Conversely, it is also possible that strategies to reduce missed care-such as staffing improvements-may improve safety climate.

Using missed care survey results to improve medication management.

In this study, 96 medical-surgical RNs completed the MISSCARE Survey with a response analysis indicating medication delays or omissions. A medication management improvement project to address administration or reassessment delays achieved improvements at 6 months.

An Overview of Missed Nursing Care and Its Predictors in Saudi Arabia: A Cross-Sectional Study.

Background Nursing care is holistic, and missing any aspect of care can be critical to patients' health. However, due to the complex and intense nature of the nursing practice, nurses have to unintentionally prioritize some activities, forcing them to omit some aspects of nursing care. Aim To explore the dimensions of missed nursing care and its predictors within the Saudi Arabian healthcare system. Methods Quantitative, cross-sectional study used the MISSCARE survey by utilizing nonprobability convenience sampling to collect the data of 604 staff nurses working in inpatient wards in Jazan, Saudi Arabia. Results The overall mean of missed nursing care is (m = 1.37, SD = 0.45). Missed nursing care activities were mostly failure to attend interdisciplinary care conferences (m = 1.66, SD = 0.96) and patient ambulation thrice a day (m = 1.63, SD = 0.97). Missed nursing care was mainly caused by human resource shortage (m = 3.53, SD = 0.88). Missed nursing care is predicted by the turnover intention (B = 2.380, t = 3.829, p < 001) and job satisfaction (B = −0.864, t = −4.788, p < 001). Conclusion Although missed nursing care is evident in Saudi Arabia, it is significantly lower than the international rates, and it is mainly caused by labor resource shortage which directly influences nurses' job satisfaction and intention to leave. Optimizing the recruitment process, resource allocation and effective nurses' retention programs are proposed solutions that may be beneficial to mitigate missed nursing care.

The Correlation of Nurse's Work Environment with Missed Nursing Care in Hospital

Introduction: Missed nursing care is a caring aspect needed for patients who have intentionally or not been eliminated or significantly postponed. One of the factors that can affect missed nursing care is the work environment of the nurse. The aspects contained in the work environment of nurses include staffing and resources; quality of basic nursing care; nurse and doctor relationship; participation of nurses in hospital affairs; as well as nurse manager ability, leadership, and nurse support. Method: This research study used correlational analysis and a cross-sectional design approach which was carried out on 56 nurses as respondents using two instruments, that is Misscare Survey and the PES-NWI questionnaire. Results: The study using the Spearman Rank test showed that there was a significant relationship between the work environment of nurses and missed nursing care (ρ &lt;0.05). Conclusions: The better nurse's work environment is lower missed nursing care.

Missed nursing care in the COVID-19 pandemic in Iran.

BackgroundQuality of care is one of the most critical issues in nursing care today. Moreover, all health care employees are responsible for providing support and high‐quality, safe care. However, nurses caring for COVID‐19 patients face problems such as unfamiliar work environments, exposure to the disease, lack of experience in their new positions, and close public and media attention. This study aimed to investigate missed nursing care and the reasons for missed nursing care during the coronavirus disease 2019 (COVID‐19) pandemic in Iran.MethodsThis cross‐sectional study included 135 nurses working in COVID‐19 units. Data were collected using the MISSCARE Survey. The significance level for the statistical tests was set at p < 0.05.ResultsMost of the participants were women and had a bachelor's degree in nursing. There was a lack of supportive and necessary care more than any other form of care. According to nurses, the most common reasons for missed care were urgent patient situations, inadequate staff, and an unexpected rise in patient volume and/or patient acuity on the unit.ConclusionGenerally, the results showed that being positioned in a new situation and unfamiliarity with the disease had a significant impact—among nurses—on the amount of care provided. Managers can use this information to solve existing missed‐nursing‐care problems and contribute to improving the quality of care.These results can be helpful in controlling missed nursing care and finding a more optimal solution for this problem; thus, we can improve the quality of care delivery and increase the satisfaction of nurses and patients. Additionally, an understanding of the kind of missing nursing care during a pandemic can positively enhance the management of similar situations in the future.