Factors Involved in Missed Nursing Care: A Systematic Review

Background. Missed Nursing Care (MNC) is experienced in nearly all health care facilities. Awareness of the aspects involved in the occurrence of MNC can lead to the improvement of the quality of patient care. This systematic review aims to answer the question: "What factors are involved in the incidence of missed nursing care?"   Methods. This systematic review follows the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) statement 2020, and includes studies published in peer-reviewed journals in the time range of 2012 to 2022. The databases used in the literature search include Sciencedirect, Cochrane Library, PubMed, ProQuest, and the Wiley Online Library. The eligibility criteria were determined based on PICOS guidelines. Quality of the studies was assessed using NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and Cochrane Collaboration’s Risk of Bias tool was used to assess the risk of bias. Three authors independently performed data extraction using qualitative analysis and reached a final agreement. Results. A total of 3611 articles were found in the database search. After removing duplicates and ineligible articles, review studies, case reports, letter to editors, not full texts, dissertations and book chapters, the remaining 16 articles were finally eligible for further analysis. In general, there were three categories of factors related to MNC, including Labor resources (workload, staff adequacy, staff characteristics, nurse-patient ratio, shift work, and nurse job satisfaction), Material sources (work environment, Personal Protective Equipment, patient care equipment), and Team work and communication (communication within nursing team, and communication with medical staff). The most common influencing factor seemed to be staffing adequacy.    Conclusion. The role of healthcare service management and leadership is central to mitigating the factors that contribute to the emergence of MNCs, especially labor resources. Metaanalytic studies are needed to find the most influential factors of MNC based on the results of all available studies.