# A Systematic Review of Stress-Related Work and Missed Nursing Care Among Clinical Nurses

## TL;DR

This review finds that stress in nurses' work is linked to missed nursing care, which can harm patient safety and quality of care.

## Contribution

This study systematically reviews the relationship between stress-related work and missed nursing care among clinical nurses globally.

## Key findings

- Stress-related work, emotional fatigue, and burnout are significantly linked to more frequent missed nursing care (p < 0.05).
- Commonly missed care types include monitoring vital signs, skin/wound care, and oral care.
- Seven cross-sectional studies from different countries support the correlation between stress and missed nursing care.

## Abstract

Background: Missed nursing care (MNCs) is a global issue with the potential to threaten patient safety and is often associated with a stressful work environment. Although stress-related work among clinical nurses is associated with MNCs, the correlation remains limited. Objective: This systematic review aimed to assess and synthesize available scientific evidence regarding the correlation between stress-related work among clinical nurses and the incidence of MNCs in hospital settings. Methods: This review was conducted according to the PRISMA guidelines. The PubMed, Scopus, and EBSCO databases were systematically searched for articles published between January 2014 and June 2025. Primary studies with quantitative, qualitative, or mixed-methods designs that examined the relationship between stress-related work and MNCs among hospital nurses were included. The data obtained were extracted and analyzed using thematic approaches. Results: A total of 244 articles were identified from the three databases. Seven studies, conducted in different countries met the inclusion criteria. All studies used cross-sectional designs. The results showed that most study reported stress-related work, emotional fatigue, and burnout were significantly positively related to the frequency of MNCs (p < 0.05). The most frequently missed types of nursing care include monitoring vital signs, skin/wound care, and oral care. Conclusions: The evidence suggests that stress-related work among nurses has significant potential to predict MNCs. Interventions that focus on mitigating work stress by improving the work environment and optimizing workload are crucial for improving quality of care and patient safety.