Strategies to prevent or minimize missed nursing management as perceived by nurse managers: a nested, qualitative-descriptive study

Introduction: The concept of Missed Nursing Management (MNM) - referring to the functions that nurse managers omit or postpone in their daily practice for various reasons - has recently emerged in the literature. However, no evidence has been published on strategies to reduce or mitigate this phenomenon. The aim of the study was to explore the strategies to avoid missed nursing management as perceived by Italian nurse managers (NMs). Methods: A nested, qualitative-descriptive study conducted in 2024 by interviewing a sample of 22 nurses. They worked as clinical nurses, nurse managers, nurse executives, nurse educators, and as members of nurse manager associations - at departmental, organisational, educational, and association levels. The audio recordings of the interviews were transcribed verbatim and analysed thematically. The COnsolidated criteria for REporting Qualitative research guidelines were followed. Results: Six strategic approaches were proposed to prevent or minimise the phenomenon of Missed Nursing Management: (1) Increasing clarity in role definition and task prioritisation; (2) Providing education and development; (3) Ensuring mentoring and promoting reflective practice; (4) Ensuring organisational and system-level support; (5) Promoting policy and cultural change; and (6) Ensuring advocacy and professional support. Conclusion: Missed Nursing Management can be limited or mitigated using multifaceted strategies at the unit, organisational, and system levels. Overall, implementation of these strategies may help minimise the risk of MNM and strengthen the ability of NMs to contribute effectively to complex healthcare systems. However, their effectiveness should be systematically evaluated.