Abstract
Aim: Identify and examine the most significant factors that, in the opinion of a nurse, may influence the occurrence of missed nursing care in hospitals.
Background: Missed nursing care is any aspect of required patient care that is delayed, wholly omitted, or partially omitted. Nurses are progressively concluding their shifts with pending tasks and essential components of patient care. The consequences of missed nursing care extend beyond immediate patient outcomes to include effects on nurse wellness, job satisfaction, and the healthcare organisation's reputation. This integrative review seeks to identify the contributing factors to missed nursing care from nurses' perspectives in hospital settings.
Methods: An integrative review was undertaken employing Whittemore and Knafl's constant comparison method. The following electronic database were explored:CINAHL, EMBASE (OVID), and EMCARE (OVID). The identified articles were then evaluated using the JBI critical appraisal tools. Eleven articles were included, and information from across the included articles were documented in an extraction table. Whittemore and Knalfs approach to analysis was followed and presented narratively.
Findings: The nurse staffing, material resources, patient dynamics, organizational procedures, leadership and time limitations collectively contribute to missed nursing care. Similarly, nurses' training, skill coordination, efficient communication, time utilization, and teamwork dynamics all contributed to patient care provision, underscoring the need for holistic strategies to achieve the best possible quality care.
Discussion: This review adds a vital perspective to the impact of leadership, nursing education and nurse supervisors on missed nursing care. It found that better leadership and nurse supervisors' active presence in a supportive environment reduce missed nursing care. Nursing managers are crucial in identifying external and internal factors hindering or enhancing nursing practice environments and monitoring missed nursing care.
Conclusion: The review highlights the importance of addressing staffing, patient dynamics, leadership practices, nurse factors, skill mix, communication, and teamwork to improve patient care quality and reduce missed nursing care incidents in healthcare settings. Further research is required into a nurse's personal and professional accountability for why missed nursing care is rarely reported.
Implications for Clinical Practice: The insights from the findings can guide nurses and policymakers in developing strategies to minimise missed care instances, ensuring a higher standard of care and improved patient outcomes while maintaining stringent quality control measures.