Nurses’ perceptions and reasons for missed nursing care in the operating room: a cross-sectional survey study

Although research on missed nursing care (MNC) has expaned, evidence based on reports from operating room (OR) nurses in China remain limited. This study investigated OR nurses’perceptions and reasons for MNC among OR nurses in China and to inform improvements in OR nursing practice. This cross-sectional study used convenience sampling to recruit OR nurses from nine tertiary grade A hospitals in Sichuan, China, between September 1 and November 1, 2025. Data were collected using an online, self-administered questionnaire comprising general information form and the Chinese version of the MISSCARE Survey-OR Scale. Multivariate linear regression was used to identify factors associated with MNC. MNC was prevalent in clinical practice. The most frequently missed care activities were using at least two identifiers to verify a patient’ s identity, confirming preoperative blood preparation and accuracy of patient information, and asking the patient or legal guardian to confirm the surgical procedure. The most frequently reported reasons for MNC were insufficient nursing team members and the absence of backup staff during intraoperative emergencies, insufficient auxiliary nursing staff and poor communication with nurses, inadequate staffing levels, and lack of guaranteed rotational rest. Univariate analysis showed that MNC was significantly associated with age, sex, marital status, educational level, professional title, work experience, weekly working hours, daily surgical volume, overtime status, employment status, and job satisfaction. Multivariate linear regression analysis showed that aged younger than 30 years, female sex, having a postgraduate degree, having less than 5 years of work experience, and working more than 60 h per week were associated with higher MNC scores. MNC appears to be relatively common among OR nurses and may play a role in patient perioperative safety. Effective measures are need to reduce the incidence of MNC and mitigate its adverse effects on surgical patients. Clinical trial number: not applicable.