Missed Care Prevalence and Associated Factors in Acute Care Settings: A Systematic Review and Meta-Analysis

The aim of the study was to comprehensively analyse the prevalence and factors associated with missed nursing care in acute care settings.

A systematic review was conducted to estimate the prevalence of missed nursing care, types of activities missed and associated factors in acute care hospital settings. Five electronic databases (CINAHL, Embase, Medline, PubMed and Scopus) were searched from inception to 14th December 2022. Type of missed care and associated factors were classified based on missed care concepts, definition and measurement. Random effects meta-analysis was performed to estimate proportions and levels of types of nursing activities missed.

A total of 45 studies recruited 139 454 nurses reporting missed care activities. The most frequent activity missed was ambulation, with estimated prevalence of 46% (95%, CI [0.37, 0.55] I² = 99.6), followed by mouthcare 36% (95% CI [0.30, 0.43], I² = 99.7%), emotional support 33% (95% CI [0.26, 0.43], I² = 99.5%), bathing 31% (95% CI [0.22, 0.41], I² = 99.6%) and feeding 30% (95% CI [0.23, 0.38], I² = 99.5%). Limited workforce capacity was a major contributor to missed care.

This study reports significant missed basic nursing activities in healthcare settings globally, suggesting greater odds of unsafe patient outcomes of hospitalisation. Targeted preventative strategies need to be tailored to specific missed care activities.