The relationship between patient safety culture and missed nursing care: a cross-sectional study in Iran

Background A robust patient safety culture is associated with improved patient outcomes, though the exact mechanisms remain uncertain. One potential factor is missed nursing care, which may mediate this relationship. Methods In this cross-sectional descriptive-analytical study, 204 nurses from teaching hospitals affiliated with Hamadan University of Medical Sciences were surveyed between June 2024 and February 2025. The study population included all nurses working in these hospitals. Participants were selected using a targeted quota sampling method after obtaining organizational permission, ethical approval, and informed consent. Data were collected using three questionnaires: a demographic information form, the Patient Safety Culture survey, and the MISSCARE questionnaire. The collected data were analyzed with SPSS version 26. Results Out of 204 returned questionnaires, 192 valid responses were analyzed. Pearson’s correlation test indicated a significant inverse relationship between patient safety culture and missed nursing care scores (r = -1.64, p = 0.033). Nurses over 30 and male nurses reported higher incidences of missed care than their counterparts, whereas other demographic variables did not show significant associations with missed care. Conclusion These findings suggest that strengthening patient safety culture reduces missed nursing care by increasing awareness of safety protocols and decreasing errors. Promoting patient safety policies and educational programs is therefore an effective strategy to enhance the quality of nursing care.