Organizational determinants of missed nursing care in surgical

Purpose: This study examined the prevalence and systemic causes of missed nursing care (MNC) in surgical units and investigated the relationship between missed care and nurses’ professional satisfaction to support global patient safety strategies. Methods: This descriptive, cross-sectional study included 107 registered surgical nurses at a university hospital in 2024. The validated MISSCARE Questionnaire was utilized, demonstrating high reliability (Cronbach’s alpha = 0.915). Data were analyzed using descriptive and inferential statistics. Results: Primary causes of MNC were insufficient workforce (87.9%) and equipment shortages (75.7%). Critical safety omissions were prevalent; 60.7% of nurses reported that timely medication administration and 57.9% reported that regular vital sign monitoring were rarely achieved. Notably, 57.9% of nurses liked their profession only at a “moderate” level, a sentiment linked to the 87.9% staffing shortage preventing quality care. Nurses who "did not like their job at all" had significantly higher MNC scores (p = 0.001), establishing that understaffed environments impair both professional satisfaction and patient safety. Conclusions: MNC in surgical units is a systemic problem caused by workforce and logistical inadequacies, threatening patient safety. Job satisfaction is a direct organizational predictor of MNC (p < 0.001), suggesting that investing in positive work environments is crucial for clinical quality. We advocate for the global implementation of surgery-specific nurse-patient ratios.