Juxtaposing Nurses' and Patients' Perspectives of Missed Nursing Care: A Descriptive Mixed Method Design.
Mirit Cohen, Anat Drach-Zahavy, Einav Srulovici
PMID 39304300WHAT IT FOUND
Nurses and patients do not agree on what nursing care is missed.
Patients prioritise dignity, timely help with toileting, and feeling valued over technical tasks. Assertive patients got their needs met, while empathetic patients stayed silent to avoid being a burden and received less care.
Key findings
01There was no statistically significant correlation between how much missed care nurses reported and how much patients reported experiencing.
02Patients prioritised relational care, such as being informed, receiving timely basic hygiene care to preserve dignity, and being treated with respect, over complex medical explanations.
03Patients who attributed missed care to systemic issues like staffing shortages often remained silent to avoid burdening nurses, which inadvertently led to further missed care.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in only two hospitals in Israel, which may limit generalisability to other healthcare systems or cultures. The inclusion criteria required patients to be alert, oriented, and able to communicate, excluding those with cognitive impairment or severe illness who may be at highest risk for missed care. The qualitative interviews were not audio recorded, relying on handwritten notes, which may have limited the depth of verbatim data captured. Different questionnaires were used for nurses and patients (MISSCARE vs MISSCARE-Patient), which may measure different constructs, complicating direct comparison.
Declared interests
The authors declare no conflicts of interest. The study was funded by the Israel Science Foundation.
The easy way to misread this
Do not interpret the lack of correlation between nurse and patient reports as evidence that nurses are inaccurate or that patients are unreliable. The study shows they are measuring different phenomena: nurses track task omissions, while patients experience care through the lens of dignity, communication, and responsiveness. Both perspectives are valid but distinct.