Hidden Factors of Limited Time and Busyness: A Qualitative, Multicentre Study of the Reasons for Missed Nursing Care

Aim: To explore nurses' perceptions of reasons for missed nursing care. Design: A multicentre qualitative descriptive study was undertaken from August 2022 to January 2023. Methods: Interpretive description methodology was used. Individual interviews were conducted with 36 registered nurses and eight licensed practical nurses working in medical, surgical and intensive care units at three public university hospitals in Denmark. Using a semi-structured interview guide, nurses were asked to share their perceptions of reasons for missed care. The analysis was guided by an inductive thematic approach. Results: The nurses' immediate responses to reasons for missed nursing care circulated around limited time and busyness. However, further analysis unfolded layers of reasons described within three themes: being challenged by workload and patients' diverse care needs; falling short on competencies; and being governed by organisational structures and decisions. Conclusions: The study underlines that reasons for missed nursing care are multiple and complex and extend from an individual to an organisational level. They can therefore not be seen nor targeted isolated. Furthermore, there is a need to draw attention to organisation of care and nurses' clinical decision-making to ensure that patient's fundamental care needs are met. Implications for the Profession: Reducing missed nursing care calls for interventions that require nurses to change their working practices, roles and value perceptions. This study provides valuable insight into nurses' perspectives on reasons for missed nursing care, which is pertinent for designing interventions targeting missed nursing care. Impact: The study provides insight into nurses' perceptions on reasons for missed nursing care within hospital settings. The findings of the study show that reasons for missed nursing care are multiple and complex and cannot be limited to time and busyness. The findings can be used to inform future interventions aimed at reducing missed nursing care. Reporting Method: The reporting of the study followed the consolidated criteria for reporting qualitative research. Patient or Public Contribution: No patient or public contribution.