Association Between Missed Nursing Care and Nurse Fatigue: A Cross-Sectional Correlational Study

Background/Objectives: Missed nursing care-defined as any aspect of required patient care that is omitted or delayed-has emerged as a significant indicator of healthcare quality. Fatigue among nurses, particularly in high-demand environments, may contribute to care omissions. This study aimed to assess the prevalence and patterns of missed nursing care and its association with occupational fatigue among nurses working in Saudi hospitals. Methods: A cross-sectional correlational study was conducted among 183 registered nurses from multiple hospitals in the Hail and Madinah regions, Saudi Arabia. Data were collected using the Missed Nursing Care Scale (MISSCARE) and the Occupational Fatigue Exhaustion/Recovery Scale (OFER-15). Statistical analysis was performed to assess the relationships between missed care, fatigue, and demographic/work-related variables. Results: Nurses reported moderate levels of missed care, especially in basic care tasks such as oral hygiene, assistance with meals, and timely ambulation. The most frequently cited causes of missed care included insufficient staffing, high patient load, and a lack of support personnel. Occupational fatigue scores were also moderate, with notably low inter-shift recovery. A significant negative correlation was found between inter-shift recovery and missed care (r = -0.120, 95% CI: -0.23 to -0.005, p = 0.040), indicating that poorer recovery between shifts was associated with more frequent omissions. Other fatigue dimensions showed weak, non-significant associations with missed care. Conclusions: Missed nursing care is a prevalent issue in Saudi hospitals and is significantly influenced by organizational factors and nurses' recovery between shifts. Interventions to improve staffing adequacy and promote rest and recovery may reduce care omissions and enhance patient outcomes.