Clinical nursing practice, missed care, and satisfaction with the use and management of IV therapy specialist nurses: a cross-sectional study and analysis of influencing factors

In China, a growing workforce of IV therapy specialist nurses faces unique practice challenges. Understanding how their clinical practice and missed care impact job satisfaction is crucial for retaining this vital specialty and ensuring quality patient care. This study aimed to explore the clinical nursing practice, missed care, and satisfaction levels regarding the use and management of IV therapy specialist nurses, as well as the factors influencing satisfaction. From March to April 2025, a cross-sectional survey was conducted among 670 IV therapy specialist nurses at 62 hospitals in Beijing using convenience sampling. Data collection involved a self-administered questionnaire that assessed demographic characteristics, clinical nursing practice, missed care, and satisfaction levels. Binary logistic regression was used to determine the significant factors associated with satisfaction. The majority of IV therapy specialist nurses (78.8%) worked in dual-capacity roles, combining general nursing duties with specialized IV therapy, and 37.2% reported missed care during their last shift, mostly involve one or two tasks. The median time spent on IV therapy was 17.4% (IQR: 7.5–36.1) of working hours, and 53.1% of the nurses expressed high satisfaction with the use and management of IV therapy specialist nurses. Logistic regression identified five key predictors of satisfaction: greater confidence in patient self-management (OR = 7.125), clear differentiation from general nurses (OR = 3.293), higher perceived care quality (OR = 3.058), and fewer years since certification (OR = 1.754), all of which contributed to higher satisfaction. Conversely, experiencing missed care (OR = 0.636) was linked to lower satisfaction. Our study identifies three significant challenges related to the use and management of IV therapy specialist nurses in China: substantial underutilization, prevalent missed care, and moderate levels of satisfaction. Healthcare institutions should adopt a multifaceted approach, including clearly defining the roles of IV therapy specialist nurses, providing adequate organizational support, and implementing career advancement initiatives to enhance workforce satisfaction and improve the quality of patient care.