Missed Nursing Care in Pandemic Crisis of COVID-19: A Systematic Review

High-quality nursing care ensures patient safety. However, missed nursing care (MNC) poses a significant risk. During the COVID-19 pandemic, the dynamic clinical environment negatively impacted nurses and patient care quality. This review examined the most frequently reported elements and contributing factors of MNCs in studies conducted during the pandemic.

This was a systematic review (PROSPERO CRD42023460938). A systematic search was conducted across databases including ProQuest, CINAHL, Web of Science, Google Scholar, Scopus, PubMed, PROSPERO, and Cochrane CENTRAL, using Boolean operators based on PICOT-SD criteria from December 2019 to July 2024. Keywords were selected based on Medical Subject Headings (MeSH) and previous studies. After reviewing the inclusion and exclusion criteria, 31 quantitative studies from 17 countries were included in the final evaluation. Findings were reported following PRISMA guidelines.

During the pandemic, MNC elements were categorized into 5 domains based on the Nursing Intervention Classification (NIC). At the same time, contributing factors were organized into 6 levels based on the MNC model. The most frequently observed MNC elements were identified in the basic physiological domain. The primary contributing factor for MNCs was the demand for patient care, with inadequate staffing being the most reported issue during the pandemic.

The SARS-CoV-2 pandemic revealed that nurses' reluctance to engage in close contact with patients for various reasons led to significant losses in care. High care demands and staffing shortages remain prevalent factors contributing to MNCs, highlighting the need for effective management strategies in future health crises.