Systemic Pressures and Nurse Decision‐Making in ICU Missed Nursing Care: A Meta‐Synthesis

Resumo

Background Missed nursing care (MNC) is prevalent in ICU settings and may negatively impact patient outcomes while increasing the professional burden on nurses. Although many studies have explored the causes and consequences of missed care, a systematic qualitative synthesis that illuminates the critical link between them is still lacking. Specifically, the decision‐making mechanisms in ICU nurses employ under systemic pressures, and how these mechanisms lead to specific care elements being omitted. Aim This meta‐synthesis aims to synthesise qualitative evidence to systematically analyse and illuminate the determinants, processes and multifaceted impacts of missed nursing care (MNC) in the ICU. Study Design The qualitative meta‐synthesis was conducted in accordance with the guidelines set by the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA). We searched 10 major databases (including PubMed, Web of Science, CINAHL, CNKI, etc.) from their inception to June 2025. Two reviewers independently assessed the methodological quality and extracted data. Thematic synthesis was used to integrate and analyse the findings. Findings Six studies satisfied the inclusion criteria. The meta‐synthesis identified the following six core themes: (1) nurses' divergent views of missed nursing care, (2) the convergence of multilevel systemic pressures behind missed care, (3) the decision‐making mechanism: nurses' strategic adaptations, (4) commonly missed elements of nursi

Tipo

Artigo

Área

Enfermagem

Ano

2026

Idioma

Inglês

Licença

CC BY-NC-ND

DOI

10.1111/nicc.70349

Como citar (ABNT)

FAN, Ya et al.. Systemic Pressures and Nurse Decision‐Making in ICU Missed Nursing Care: A Meta‐Synthesis. Nursing in Critical Care, v. 31, n. 2, 2026. DOI: 10.1111/nicc.70349.