Missed nursing care in surgical units: A cross-sectional study on prevalence, causes, and influencing factors
Susanne Ahlstedt Karlsson1, Elin Svenningsson2, Hanna Järbrink3
1Department of Plastic Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Bla Straket 3, SE-413 45, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, University of Gothenburg, Box 547, SE-405 30, Gothenburg, Sweden; Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Medicinaregatan 3, SE-413 90, Gothenburg, Sweden.
Background:
Missed nursing care (MNC) is defined as any aspect of patient care that is either omitted (in part or in whole) or delayed. Consequently, the potential risks associated with MNC represent a significant threat to patient safety. Identifying MNC is essential for enhancing patient safety, the quality of care, and the overall efficiency of the healthcare system.
Aim(S):
To investigate the type, prevalence, and reasons for MNC within a surgical context, and to investigate associations between MNC, work-related factors, and individual characteristics of the nursing staff.
Methods:
A cross-sectional design was employed. Data were collected online from November to December 2024 using the MISSCARE survey - Swedish Version 2.0. Registered nurses (RNs) and nurse assistants (NAs) from three surgical units at one Swedish university hospital participated (n = 84).
Results:
Most MNC involved basic care and individual needs, with the most frequently missed items being ambulation (78.0 %), mouth care (77.1 %), and turning (73.5 %). The main reason for MNC was lack of labor resources (59.7 %). Over three-quarters of the respondents reported inadequate staffing, interruptions/multitasking, and unexpected increases in patient volume or acuity as significant reasons. Analysis of associated factors indicated that reported MNC and contributing factors may vary according to professional role, work experience, and unit type as less experienced nurses reported higher MNC rates in an acute setting.
Conclusion:
MNC frequently occurs in surgical units, and is particularly reported in acute care. The discrepancy between nursing staff levels and patient acuity forces the prioritization of essential nursing tasks.
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