Missed nursing care in community-based health care: A scoping review.

BACKGROUND

Missed nursing care is widely recognized as a complex phenomenon associated with care quality and patient safety. Although extensively studied in hospital settings, evidence on its determinants and consequences in community and home care remains limited.

AIM: This scoping review synthesizes the available literature on missed nursing care in community-based care settings, identifying causes, consequences, and measurement tools.

METHODS

The study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and Joanna Briggs Institute guidance, using the Population-Concept-Context framework. PubMed, Scopus, and Web of Science were searched with no time restrictions. The search was completed on August 1, 2025. Data were extracted using a standardized form and narratively synthesized into thematic categories.

RESULTS

Fifteen studies were included. The findings were synthesized into four main areas: (1) measurement tools and approaches used to assess missed nursing care; (2) prevalence and types of missed nursing care; (3) individual and interpersonal factors influencing missed nursing care; and (4) organizational, systemic, and contextual factors influencing missed nursing care. Two studies focused specifically on the development and psychometric validation of context-specific instruments for primary and home care settings. Across empirical prevalence studies, omissions most frequently concerned documentation, patient and family education, psychosocial support, and preventive or rehabilitative activities. Commonly reported associated factors included staffing constraints, workload pressure, burnout, communication fragmentation, and limited hospital-community integration.

CONCLUSIONS

The literature on missed nursing care in community-based and residential long-term care settings remains limited, with restricted geographical diversity and heterogeneous measurement approaches that are not yet internationally standardized. Although context-specific instruments have recently been developed, further validation and cross-context testing are needed. Future studies should focus on assessing the impact of missed nursing care on care quality and developing strategies to address omissions in community and home nursing care.