Links Between Staffing and Resource Inadequacy and Missed Nursing Care in an Academic Medical Center (Eastern Province, Saudi Arabia): A Cross-Sectional Study

<b>Background:</b> Missed nursing care, defined as essential patient care that is omitted or delayed, is a growing source of concern due to its effects on healthcare quality and patient safety. Our aims in this study were twofold: first, we examined the extent and types of missed nursing care, and second, we analyzed the relationship between the care missed by hospital nurses and the staffing and resource adequacy in an academic medical center. <b>Methods:</b> A descriptive cross-sectional study was conducted during the period between November 2022 and July 2023. Data were collected using a self-administered questionnaire that comprised items on socio-demographic and work-related characteristics, items on staffing and resource availability, and items from the 'MISSCARE' Survey. <b>Results:</b> The most frequently missed nursing care involved pressure-relieving interventions (Mean = 2.39) and ambulation/mobilization (Mean = 2.27), while medication administration (Mean = 1.60) and glucose monitoring (Mean = 1.56) were missed the least. Labor resource inadequacy (β = 0.315, <i>p</i> < 0.001) and communication and teamwork deficits (β = 0.285, <i>p</i> < 0.001) were positively associated with missed nursing care, whereas staffing and resource adequacy showed an inverse association (β = -0.164, <i>p</i> = 0.006). The model explained 49.8% of the variance in missed nursing care (R² = 0.498). <b>Conclusions:</b> These findings highlight that missed nursing care is a system-level issue primarily associated with staffing and resource constraints rather than individual characteristics. Improving staffing adequacy, resource availability, and interprofessional collaboration may reduce care omissions and enhance patient safety in Saudi Arabian academic medical centers.