Abstract
Background: Nurses’ systemic challenges drive missed nursing care (MNC), linked to adverse outcomes. Despite global MNC rates of 55–98%, old adult patients in emergency departments (EDs) are understudied. This study examines MNCs and their underlying reasons from the perspective of nurses and old adult patients referring to EDs.
Methods: This descriptive-comparative study enrolled 150 eligible nurses and 150 old adult patients from five teaching hospitals in Tabriz, in 2024. Data were gathered using validated questionnaires on missed care and its underlying reasons (specific versions for nurses and patients) (Cronbach’s α = 0.90-0.95). Descriptive statistics, the t-test of independent groups, and one way analysis of variance were used to analyze the data.
Results: Patients (50% female) prioritized unmet educational needs, while nurses (65.3% female) emphasized physical care and privacy lapses. The mean scores of MNCs were significantly higher in patients (75.02 ± 17.32 vs. nurses’ 51.66 ± 17.98, p < 0.001). The mean scores of underlying reasons differed significantly between groups (nurses: 52.17 ± 11.11; patients: 46.98 ± 7.38, p < 0.001). The shortage of nursing staff and unit overcrowding were identified as common MNCs reasons in both perspectives.
Conclusion: This study revealed a perceptual divide between nurses and patients regarding MNCs and their reasons. Patients reported a higher extent of MNC, whereas nurses emphasized the contributing factors with greater intensity. Multifaceted interventions such as geriatric-specific skill training for nurses and optimized nurse-to-patient ratios are recommended to reduce MNCs.