Aim: To determine the prevalence of, and reasons for, missed care by nurses and the factors associated with it in Iranian hospitals. Background: Despite providing high-quality patient care in hospitals, nurses often fail to deliver optimum care, which jeopardizes the safety of patients and increases health care costs. Therefore, identifying missed nursing care is essential if the quality of health services is to be improved. Methods: A cross-sectional study was conducted among 215 nurses working in the medical-surgical wards of eight public and private hospitals in Tabriz, Iran. The 'MISSCARE' survey tool was used to collect data in relation to the extent of missed care and the related reasons. Logistic regression models were used to assess the association between factors and missed nursing care. Results: Results showed that the mean score of overall missed nursing care was 2.57 and 72.1% of the nurses reported that they missed at least one nursing care item on their last shift. 'Patient discharge planning and teaching', 'emotional support to patient and/or family' and 'attend interdisciplinary care conferences whenever held' were the most common missed items by nurses in Iran. In a 5-point Likert scale, the most important reasons identified by nurses for missed care were 'human resources', 3.11 (95% CI: 3.03-3.19); 'material resources', 2.7 (95% CI: 2.6-2.8); and 'communication', 2.4 (95% CI: 2.3-2.5), respectively. Missed nursing care was associated with sex (OR for males = 2.83, 95% CI: 1.01-7.89), age (OR = 1.16, 95% CI: 1.01-1.33) and the number of patients under care (OR = 1.11, 95% CI 1.01-1.22). A reverse association was found with the number of patients discharged (OR = 0.89, 95% CI: 0.82-0.96) and satisfaction with teamwork (OR = 0.60, 95% CI: 0.41-0.89). Conclusions: There is a need to identify the factors contributing to the incidence of missed nursing care in hospitals and to develop strategies to address these. Implications for Nursing Management: The results of this study highlighted the importance of addressing missed nursing care in Iranian public and private hospitals. Nursing management should consider improving communication between team members and units. Changes are required regarding task division and payments to How to cite this article: CheginiZ, Jafari-Koshki T, Kheiri M, et al. Missed nursing care and related factors in Iranian hospitals: A cross-sectional survey.

Aims To assess nurses' burnout and its association with their perceived quality of patient care and occurrence of adverse events (AEs) during COVID‐19. Background Burnout is a serious problem among nursing staff internationally with negative impacts on the quality of care and patient safety. Methods We conducted a cross‐sectional online study among 1,004 Iranian nurses through the convenience sampling technique. Data were collected using the Maslach Burnout Inventory, five items of questions related to self‐reported poor patient care quality and estimated occurrence of AEs. Results Prevalence of high burnout among nurses was 31.5%. The risk of AEs ranged from 26.1% to 71.7%. Self‐reported quality of patient care was found to be poor. A positive correlation was found between emotional exhaustion and depersonalization scores and patient care quality, whereas a negative correlation was found between personal accomplishment scores and all poor care item scores. Depersonalization was found to increase the risk of the onset of all AEs (odds ratio [OR] = 1.06–1.08). Also, Personal accomplishmentreduced the risk of occurrence of ‘medication errors’ (OR = 0.99) and the onset of ‘patient and their family verbal abuse’ (OR = 0.97). Conclusions Our findings confirmed the hypothesis that a higher degree of burnout is correlated with a perceived higher number of AEs and reduced perceived patient care quality. Implications for Nursing Management Reducing burnout among nurses through implementing interventions may be an effective strategy to enhance patient care quality and reduce the number of AEs in Iranian public hospitals. Therefore, in order to minimize work burnout, primary approaches include access to psychosocial support, including Web‐based services, psychological first aid, mental support hotlines and self‐care techniques during the COVID‐19 pandemic.

Aim This study sought to describe the experiences of critical care nurses caring for patients infected by coronavirus disease 2019 (COVID‐19). Design A qualitative phenomenological design was used. Methods We enrolled 15 nurses who provided care for patients infected by COVID‐19 purposively and through snowballing, using a phenomenological approach in critical care units of Iran's public hospitals between May and June 2020. The semi‐structured interviews were carried out either via face‐to‐face or telephone and were analyzed using the 7‐step method of Colaizzi. Results The experiences of nurses caring for patients infected with COVID‐19 were categorized into four challenges, including psychological (eight subthemes), organizational (six subthemes), social (six subthemes), and professional (five subthemes). In general, based on the current classification, there seems to be a mixture of positive and negative effects on the psychological, social, and professional challenges and the negative effect only on the organizational challenges. Conclusions Positive and negative emotions and experiences have coexisted for the critical care nurses since the COVID‐19 outbreak. Emotional support and psychological counseling play an important role in maintaining nurses' optimal mental health during the COVID‐19 crisis. Adequate protective equipment, financial and nonfinancial supports, effective communication, training and hiring of staff, and appropriate work shifts are also required to reduce nurses' negative experiences when providing care for the affected individuals.

Background Turnover intention is a frequent event in almost all institutions and is associated with unfavourable consequences for employees. Aim The aim of this study was to examine the relationship between occupational stress, quality of working life and turnover intention amongst nurses working in critical care units in Iran. Design A cross‐sectional survey design was used. Method The study was conducted in the critical care units of 10 hospitals in Tabriz, Iran, between July and November 2017 using a sample of 203 nurses. Data were obtained using a self‐administered questionnaire, and multiple logistic regression analysis was performed to determine the factors impacting turnover intention. Results Overall, 64% of nurses had an intention to leave their job; 82·8% of respondents reported their job to be highly stressful, and 81·2% reported their quality of working life to be low. Binary logistic regression analysis indicated that age (p = 0·006), clinical experience (p = 0·005), duty stressors (p = 0·040), interpersonal relations stressors, (p = 0·029) communication (p = 0·007), motivation (p = 0·006), job security (p = 0·040) and job pride (p = 0·011) were factors affecting turnover intention. Conclusion Occupational stress and quality of working life are associated with turnover intention amongst nurses working in critical care units. Further research is needed to determine the generalizability of these results to other settings and countries and to identify interventions that could reduce occupational stress and improve the quality of working life so that turnover intention might be reduced. Relevance to clinical practice The findings of this research suggest that lower perceived occupational stress and higher quality of working life will result in less reported turnover intention in critical care unit nurses.