Correlates of Patient and Nurse Missed Care: A Multi-Hospital Cross-Sectional Study

To determine the prevalence of missed care in inpatient surgical wards and to examine the causes and consequences of missed care from the perspectives of patients and nurses.

This study employed a descriptive, correlational, cross-sectional design.

This study was conducted over 3 days in November 2023 and included 354 patients and 89 nurses working in surgical wards of city hospitals. Data were collected using the Patient and Nurse Identifying Information Form, the MISSCARE Survey-Patient, and the MISSCARE Survey-Nurse. The data were analysed using SPSS. The study was reported in accordance with the STROBE checklist.

Patients reported that oral care, body care and mobilization were care activities that were most frequently not performed. Patients' educational level and age did not affect the MISSCARE Survey-Patient scores, whereas duration of hospitalization and gender had a significant effect on the scores. According to nurses, the most frequently missed nursing care need was turning the patient every 2 h. Nurses also reported that an insufficient number of auxiliary and technical personnel, as well as unexpected increases in patient numbers and workload intensity in the unit, were major reasons for missed care. Gender, educational level, job satisfaction, age, years of employment, and weekly working hours did not significantly affect the MISSCARE Survey-Nurse scores of the nurses.

The results indicate that missed nursing care is a significant problem from both patient and nurse perspectives. Communication deficiencies and insufficient staffing negatively affect the quality of care. Health institutions should focus on improving communication, staffing levels, and teamwork to enhance care quality.

This study highlights the persistent issue of missed care from both patient and nurse perspectives. The findings demonstrate that basic care needs, such as oral hygiene, mobilization, and personal care, are frequently unmet. Contributing factors including communication breakdowns, insufficient staffing, and workload imbalance were identified. These results underscore the need for nursing managers to reassess resource allocation, strengthen interdisciplinary communication, and support care planning strategies that prioritize fundamental care. The study offers valuable guidance for clinical nurses and nurse leaders aiming to enhance patient safety and improve the quality of care in surgical wards.

The findings of this multi-centre study may inform nursing management practices in acute surgical settings, particularly in middle- and low-resource health systems where staffing shortages are common. The dual-perspective approach, incorporating both patient and nurse views, provides a more comprehensive understanding of care gaps. This perspective may influence policy decisions, staff allocation and training programs. The results may also guide future interventions aimed at reducing adverse patient outcomes associated with missed care.

Patients participated in this study by completing the MISSCARE Survey-Patient tool and sharing their experiences of missed care needs during hospitalization. Their perspectives were essential in identifying gaps in basic nursing care and potential adverse events associated with care omissions. Although patients were not involved in the study design or data analysis, their contributions informed the interpretation of the findings and supported the development of practice recommendations aimed at improving person-centred care in surgical wards.

This study was reported in accordance with the STROBE (Strengthening the Reporting of Observational Studies in Epidemiology) checklist for cross-sectional studies.