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Missed Nursing Care, Level of Staffing, and Job Satisfaction: Lebanon Versus the United States

Kalisch, Beatrice J. PhD, RN, FAAN; Doumit, Myrna PhD, RN; Lee, Kyung Hee PhD, RN; Zein, Joanna El MSN, RN

Journal of Nursing Administration: May 2013 - Volume 43 - Issue 5 - p 274–279
doi: 10.1097/NNA.0b013e31828eebaa

Missed nursing care refers to omission of standard required nursing care of patients in acute care hospitals. The objective of this study was to compare the amounts and reasons of missed nursing care, the level of nurse staffing, and job satisfaction between the United States and Lebanon. Several studies in the United States have shown that a significant amount of care is being missed. This study is designed to determine if Lebanon is experiencing a similar phenomenon and what reasons are given for missing nursing care. Findings support that a substantial amount of nursing care is missed in Lebanon, although less than that in the United States (t = 11.53, P < .001), that nurses in Lebanon were less satisfied with being a nurse than are nurses in the United States, and there was no difference in the identification of staffing resources as a reason for missed care in the 2 countries.

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Author Affiliations: Titus Distinguished Professor of Nursing and Director (Dr Kalisch), Innovation and Evaluation, School of Nursing, University of Michigan, Ann Arbor; Associate Professor and Assistant Dean of Nursing (Dr Doumit), Alice Ramez Chagoury School of Nursing, Lebanese American University, Beirut, Lebanon; Postdoctoral Fellow (Dr Lee), School of Nursing, Duke University, Durham, North Carolina; Course Coordinator, Lecturer, and Clinical Instructor (Ms Zein), Global University, Beirut, Lebanon.

This study was funded in part by the Blue Cross Blue Shield Foundation of Michigan.

The authors declare no conflicts of interest.

Correspondence: Dr Kalisch, Innovation and Evaluation, School of Nursing, University of Michigan, 400 N Ingalls St, Ann Arbor, MI 48109 (

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