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Qualitative study - other
Likelihood of nursing care being missed is influenced by several work-based factors
  1. Andres Azuero
  1. School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
  1. Correspondence to Dr Andres Azuero, University of Alabama at Birmingham, School of Nursing, Birmingham, AL 35294, USA; andreo{at}

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Commentary on: Blackman I, Lye CY, Darmawan IGN, et al. Modeling missed care: implications for evidence-based practice. Worldviews Evid Based Nurs. 2018. doi: 10.1111/wvn.12285

Implications for practice and research

  • Accumulating evidence, both through objective data and self-report, supports the influence of nursing work conditions such as staffing and skill mix on the likelihood of care being missed.

  • In absence of objective data, self-report measures may provide proxy yet useful information about the relationships between nursing work environment and care quality.


In the past two decades, a compelling body of evidence1 2 has linked higher nurse-to-patient ratios, higher proportion of baccalaureate-prepared nurses and higher total nursing care hours to lower patient mortality, decreased length of stay and a lower likelihood of patient complications such as nosocomial infections and pressure injuries. Many of these studies used a complex mix of data sources including medical and administrative hospital records from which patient outcomes, …

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