# Missed Care Prevalence and Associated Factors in Acute Care Settings: A Systematic Review and Meta‐Analysis

## TL;DR

This study finds that basic nursing care like ambulation and mouthcare is frequently missed in hospitals, likely due to staffing shortages, and suggests strategies to address this global issue.

## Contribution

The study provides a global meta-analysis of missed nursing care prevalence and identifies key factors contributing to it, offering targeted recommendations for improvement.

## Key findings

- Ambulation was the most frequently missed nursing activity, with a prevalence of 46%.
- Inadequate staffing and material resources were identified as major contributors to missed care.
- Basic care activities like bathing and feeding were also commonly missed, with prevalence rates above 30%.

## Abstract

The aim of the study was to comprehensively analyse the prevalence and factors associated with missed nursing care in acute care settings.

A systematic review was conducted to estimate the prevalence of missed nursing care, types of activities missed and associated factors in acute care hospital settings. Five electronic databases (CINAHL, Embase, Medline, PubMed and Scopus) were searched from inception to 14th December 2022. Type of missed care and associated factors were classified based on missed care concepts, definition and measurement. Random effects meta‐analysis was performed to estimate proportions and levels of types of nursing activities missed.

A total of 45 studies recruited 139 454 nurses reporting missed care activities. The most frequent activity missed was ambulation, with estimated prevalence of 46% (95%, CI [0.37, 0.55] I
2 = 99.6), followed by mouthcare 36% (95% CI [0.30, 0.43], I
2 = 99.7%), emotional support 33% (95% CI [0.26, 0.43], I
2 = 99.5%), bathing 31% (95% CI [0.22, 0.41], I
2 = 99.6%) and feeding 30% (95% CI [0.23, 0.38], I
2 = 99.5%). Limited workforce capacity was a major contributor to missed care.

This study reports significant missed basic nursing activities in healthcare settings globally, suggesting greater odds of unsafe patient outcomes of hospitalisation. Targeted preventative strategies need to be tailored to specific missed care activities.

Missed nursing care is an important health problem impacting health care systems across the globe.Inadequate nurse staffing and material resources are two important reasons for missed nursing care occurrence.

Missed nursing care is an important health problem impacting health care systems across the globe.

Inadequate nurse staffing and material resources are two important reasons for missed nursing care occurrence.

Meta‐analysis showed that the most frequently missed nursing activities reported across the globe were found to be within the domain of fundamental or basic, care.Nurses are frequently unable to fully provide for hospitalised patients' care needs such as ambulation, mouthcare, emotional support, bathing and feeding.

Meta‐analysis showed that the most frequently missed nursing activities reported across the globe were found to be within the domain of fundamental or basic, care.

Nurses are frequently unable to fully provide for hospitalised patients' care needs such as ambulation, mouthcare, emotional support, bathing and feeding.

This study contributes to nursing knowledge and practice, indicating the need for awareness creation and/or educational programs on missed nursing care for both nurses and consumers.Strengthening nursing capacity, involving nurses in addressing missed care and establishing preventative systems are recommended to help reduce missed care and its associated risks.

This study contributes to nursing knowledge and practice, indicating the need for awareness creation and/or educational programs on missed nursing care for both nurses and consumers.

Strengthening nursing capacity, involving nurses in addressing missed care and establishing preventative systems are recommended to help reduce missed care and its associated risks.