Latent profiles and influencing factors of missed nursing care among ICU nurses

Abstract

Missed nursing care (MNC) is common in intensive care units (ICUs) and seriously threatens patient safety. Most existing studies treat ICU nurses as a homogeneous group, overlooking within-group heterogeneity. Based on the Job Demands-Resources model, this study aimed to identify latent profiles of missed nursing care among ICU nurses and examine their influencing factors. A cross-sectional study was conducted from November 30, 2025, to March 31, 2026. A convenience sample of 332 ICU nurses was recruited from five tertiary Grade A hospitals in Sichuan, China. Data were collected using the Missed Nursing Care Scale, Moral Sensitivity Questionnaire, and Perceived Organizational Support Questionnaire. Latent profile analysis, correlation analysis, hierarchical regression, and multinomial logistic regression were used for analysis. The overall score of missed nursing care was 67.54 ± 21.33. Three subgroups were identified: low (56.63%), moderate (28.31%), and high (15.06%) missed nursing care. The high group had the highest missed care scores and the lowest perceived organizational support, while the low group had the highest moral sensitivity and the highest proportion of ICU specialist nurses. The pattern of missed nursing care differed across profiles: the low group mainly reported omissions in supportive nursing activities, the moderate group showed additional deficits in care planning, and the high group demonstrated omissions in core clinical care activities, including sedation and analgesia management. The total moral sensitivity score was negatively associated with missed nursing care overall, and this association was significant only in the low MNC subgroup. Lower perceived organizational support was associated with membership in the high MNC group relative to the moderate group. Hierarchical regression identified monthly overtime, dissatisfaction with human resource allocation and communication climate, ICU specialist nurse qualification, moral sensitivity, and perceived organizational support as factors associated with missed nursing care. Missed nursing care among ICU nurses shows clear heterogeneity and can be divided into three subgroups. The associations of moral sensitivity and organizational support might be context-dependent. Stratified interventions tailored to subgroup characteristics may help address missed nursing care, though their effectiveness requires testing in future studies. Not applicable (this study is an observational study, not a randomized controlled trial). Not applicable.