Mapping the Contributing Factors to Missed Nursing Care in Hospital Settings During a Global Health Crisis: A...

Little foreknowledge and preparation exist for health-related crises, and they do not match the magnitude of the problem. During the COVID-19 pandemic, nursing care in some countries faced more challenges. One of these challenges was missed nursing care. This scoping review aims to identify and map the factors influencing missed nursing care in hospital settings during the COVID-19 pandemic in studies conducted in developed and developing countries.

A scoping review was conducted according to methodology recommended by the Joanna Briggs Institute (JBI). We searched five databases-PubMed, Scopus, CINAHL, ProQuest, and Web of Science-as well as the Google Scholar search engine, from December 2019 to July 2025. Keywords of the study were selected according to the Medical Subject Headings (MeSH) and previous research. We included studies in hospital wards that examined missed nursing care and related concepts, specifically those whose data collection periods occurred during the COVID-19 pandemic. Language restrictions were not applied. The factors were derived inductively, considering conceptual similarities, relevance to the core themes, and similarities in meaning, including aspects related to the missed nursing care model, the developed model derived from it related to the factors considered for missed nursing care, and emerging challenges introduced by COVID-19. Findings were reported following the PRISMA-ScR.

From the 1966 studies, we included 57 articles in the final review. Among them, 50 were cross-sectional, four were qualitative, two were mixed, and one was quasiexperimental. They were conducted mainly in Iran and the hospital units. Four main themes and nine subthemes emerged (1) work environment (structure, work climate), (2) nurse characteristics (individual and professional, personal), (3) workflow characteristics (intensity, predictability, risk), (4) country (developed, developing). Although the lack of human resources was reported in most studies, it was not the most significant contributing factor.

These findings can inform the development of strategies to address underlying factors affecting workflow, such as nurses' attitudes and the work environment, thereby enhancing adaptability to future global health crises and serving as a crucial policy foundation for mitigating the missed nursing care during health emergencies.

These findings not only complement other global research exploring the reasons behind missed cares in nursing but also offer a framework for understanding and anticipating reported instances of missed care, enabling targeted interventions to address them effectively.