missed nursing care during the covid-19 pandemic in educational and medical centers in northern iran: a cross-sectional study

Background: nurses are the first point of contact in hospitals and play a significant role in providing high-quality care. missed nursing care has been shown to be associated with poorer patient outcomes, increased mortality, medication errors, falls, and hospital-acquired infections. objectives: this study aimed to investigate missed nursing care and its causes and related factors in the north of iran. methods: this cross-sectional study was conducted during the covid-19 pandemic in rasht, iran, from january to march 2021. a total of 326 nurses from non-emergency wards of 7 medical centers were enrolled using a simple random sampling method. the data on demographic characteristics, occupational stress (using the expanded nursing stress scale [enss]), and missed nursing care and its causes(using the misscare questionnaire) were collected. data were analyzed by descriptive statistics and multiple logistic regression analyses. results: sixty-nine percent of nurses reported that at least 1 aspect of nursing care was missed occasionally, often, or frequently. also, the median number of missed care items reported on each shift was 4 out of 25. attending interdisciplinary care conferences (46%), interventions for basic care (45%), and psychological supports for patients (42%) were the most omitted items. the most stated reason was human resources (53%). also, the occurrence of occasionally, often, or frequently missed care was significantly related to a higher level of nursing occupational stress (adjusted odds ratio [or], 2.12; 95% ci, 1.28 - 3.52; p < 0.001) and rotating shift work compared to day shift work (adjusted or, 4.54; 95% ci, 2.38-9.10; p = 0.003). conclusions: nursing missed care is relatively prevalent in the north of iran. human resources, work shift schedules, and occupational stress play an important role in missed nursing care during the covid-19 pandemic. it is necessary for policymakers and nursing managers to use strategies to optimize manpower and equipment, develop a standard work shift, and reduce stress in the workplace to improve the quality of patient care.