A Bibliometric Analysis of Missed Nursing Care Research: Current Themes and Way Forward

Background . Missed nursing care adversely afects nurse and patient outcomes in healthcare settings. Comprehensive bibliometric overview of research output in this feld is limited, which restricts knowledge of this complex phenomenon in terms of research trends, author’s productivity, and thematic focus of scientifc publications. Tis study aims to examine publications on missed nursing care by conducting a comprehensive bibliometric analysis. Methods . A search was performed in the Scopus database to identify 276 published studies on missed nursing care from inception to 20th February 2022. A bibliometric approach was used to comprehensively analyse retrieved publications based on trend, thematic focus, and scientifc production. Te R based software was used for data analysis. Results . Te result from this bibliometric analysis indicates that the frst study performed on the concept of missed nursing care was published in 2006. Te United States of America (USA) ranked frst in number of publications, and the study by Ball et al. published in 2014 was the most cited paper among the documents analysed. Te results also identifed names of prolifc authors such as Kalisch B.J., Ausserhofer D., Willis E., Papastavrou E., Schubert M., Palese A., Simon M., and Aiken L. H. and relevant institutions in this feld. Trending keywords identifed included “missed nursing care,” “unfnished nursing care,” “patient safety,” and “care left undone.” In addition, thematic analysis showed emerging themes such as “neonatal intensive care unit,” “patient satisfaction,” “health resources,” “failure to maintain,” and “adverse events.” Conclusion . Findings from this study reveal a lack of bibliometric analysis in missed nursing care research. Tis study provides signifcant contribution by presenting a comprehensive overview on thematic focus, hotspots studies, and directions for future research in this feld. Findings from this study can guide scholars in defning research focus and aspects of research on missed nursing care for future exploration.


Introduction
Missed nursing care (MNC) has been widely reported in healthcare settings such as acute care [1], community care [2,3], and paediatric and neonatal care [4]. Te term MNC is defned as any aspect of nursing care that is partly or fully left undone [5]. Tis term was frst conceptualised by Kalisch [6] in a qualitative study which identifed that nurses frequently missed elements of patient care such as hygiene, documentation of intake and output, patient teaching, ambulation, and patient feeding and turning.
Research fndings have demonstrated that MNC such as not administering medication, delaying giving medication before or after the scheduled time, missing hand hygiene, not turning, or helping patient to ambulate can lead to undesirable patient outcomes including medication errors, pressure injuries, and hospital acquired infections [7]. MNC can also contribute to emotional exhaustion and depression impacting nurses' wellbeing, causing staf shortage, and intensifying workload [8]. Over the past 16 years, some institutional and country collaborations have been developed to study MNC and nurse-patient outcomes [1,9].
With the prevalence of MNC becoming more apparent [10], this phenomenon is expected to continue across healthcare systems. Following this increase in prevalence of MNC, some review articles have been conducted to identify and synthesize existing evidence on frequently missed care, predictors of MNC, and the impact on nurses and patients [11]. Papastavrou et al. [12] reviewed quantitative evidence on types, factors, processes, and impact of MNC and found that family communication, ambulation, and mouth care were frequently MNC. In addition, increased nurse workload and barriers to communication were linked to MNC. Furthermore, patient outcomes such as falls, hospital acquired infections, and patient dissatisfaction were reported. Lastly, nurse participants in the study linked job satisfaction to less MNC [12]. Similar results have been reported by Jones et al. [13] in their review that identifed patient outcomes such as falls, medication errors, hospitalacquired infections, and moral distress among nurses leading to intention to leave. Recent reviews have shown that MNC is a contributing factor to undesirable nursepatient outcomes [14][15][16][17].
Overall, these studies have signifcantly improved researcher's understanding of the elements of care missed and the association between nurse and patient outcomes. It should be noted that irrespective of the increasing global prevalence (55-90%) and awareness of MNC across health care systems, no universal defnition or measurement of MNC exist [13]. Related terminology such as implicit rationing of nursing care, care left undone, task undone, unfnished nursing care, and rationed care has been used interchangeably [13].
Although literature reviews on MNC have synthesized past study fndings to provide scientifc insight in this phenomenon, up to now, little attention has been paid to the bibliometrics of trends in MNC research studies based on global scientifc research output. Hence, it remains pertinent to explore the extent of MNC worldwide by aggregating research trends and milestones for future directions. It is essential to use bibliometric or science mapping, a quantitative approach to capture publications trends on MNC including scholars' productivity and thematic focus in this domain. Tis study compliments existing reviews that use systematic methods to examine MNC. Te results from this review will provide better understanding to the landscape of research on MNC, help in expanding the current knowledge structure about the phenomenon, aid in the identifcation of well-developed research areas, and help to gain insight in emerging and under-researched themes that need to be further researched. In addition, the fndings of this study can be used by nurse researchers and policy makers as a point of reference in navigating the feld of MNC.
Te aim of this paper was to present a comprehensive review of current scientifc production on MNC using a bibliometric analysis. Te authors were interested in determining the trends of published literature on MNC such as document type, document content, author information, and author collaboration. An additional aim was to determine productive authors, institutions, country, and collaboration network. A notable aim of this research was to use mapping analysis to visualise authors' production and themes of interest and how themes have evolved over the years. In addition, analysis of author's keywords was performed. To the best of the research teams' knowledge, no study has used a bibliometric approach to analyse MNC scientifc research production. Tis study flls the knowledge gap and presents an overview on prolifc research themes and directions for future research in this domain.

Methods
Bibliometric analysis is the use of statistical methods to analyse materials such as books, articles, and publications. Bibliometric method is useful in providing objective, reliable, and structured point in time analysis of trends over time, shifts in disciplines, research themes, and most productive authors and author institution, thereby presenting a broader picture of the feld researched through time [18,19]. Donthu et al. [20] have concluded that the use of bibliometric approach is an expedient way to investigate trends in research domains such as topics and conceptual and intellectual structure. Research studies in various felds including nursing have used bibliometric analysis to evaluate developments in specifc specialities such as cancer [21], nursing research [22,23], orthopaedics [24], tuberculosis [25], and diabetes [26]. Although extensive research has been carried out on MNC, no previous study has used the bibliometric approach to understand the conceptual and intellectual structure of this research domain.
To overcome this limitation, this research used a science mapping approach to understand the topical foci of MNC research. Te use of science mapping in bibliometric studies helps researchers to understand the extent of the topic, emerging trends, and domain evolution over time [27]. According to Bhattacharyya and Verma [28], this approach is holistic and objective and provides better understanding compared with the traditional literature review.
To address the aim of this study, publications were obtained from the Scopus database. Te authors selected this database which ensures a wide range of peer-reviewed journals with high-quality compared to databases such as Google scholar, PubMed, and Web of Science [29]. Existing literature related to the domain of MNC in Scopus was retrieved using the following search query: ("missed nursing care" OR "unfnished nursing care" OR "care left undone" OR "ration * of nursing care" OR "omitted nursing care" OR "unmet nursing care"). Te keyword search in Scopus database was set to include articles, abstracts, and keywords to capture all relevant publications. Te search for literature was set to include published articles from January 2006 [6] to 20th February 2022. Te initial search query yielded 385 documents. Documents were further refned by document type and language. Only "articles" and "reviews" written in English language were considered for analysis. Documents such as "meeting abstracts" (n � 18), "editorial materials" (n � 17), "early access" (n � 15), "letters" (n � 3), "news items" (n � 1), and "proceeding papers" (n � 1) were excluded. Documents (n � 11) written in languages other than English were also excluded. No time limiters were applied to the search query. Te remaining 319 documents were further refned by reading through article abstracts to identify duplicates and unrelated terminologies; 43 out of the 319 studies were further excluded. Te search query used to retrieve relevant articles based on the inclusion criteria was reviewed by the librarian of the academic institution. Nursing Forum Figure 1 illustrates the research design for this bibliometric study, and the inclusion and exclusion criteria are presented in Table 1.
Overall, a total of 276 relevant articles were retrieved from the Scopus database. Next, the data (276 articles) were exported and saved in plain text fle and fnally loaded and analysed in R statistical software using the package Bibliometrix and Biblioshiny https://www.bibliometrix.org/ home/index.php/layout/biblioshiny [18]. In order to maintain quality and reliability of this study, all the researchers were involved, and they reviewed the material independently and conferred on the data quality [30].
To investigate the annual trends of scientifc production on MNC from inception to 20 th February 2022, the retrieved documents were analysed using diferent aggregation levels in the bibliometrix software. Regarding document source, the software provides indicators such as number of publications, relevant sources, most relevant authors, total number of citations, and afliations/institution productivity. Since research productivity alone in any given domain is not enough to provide substantial understanding, normalised citation analysis has proven to be a valuable technique used to assess the impact of research output. Tis technique allows a better understanding of research impact and provides equal credit to both older and current publications [31]. Tus, this technique was applied in this study. In addition, the analysis of thematic map, co-occurrence network, collaboration network, word cloud, and trend topics are also provided. Te analysis was based on author keywords which are words or phrases chosen by authors to refect document content and has been widely used in bibliometric studies [32]. Te minimum keyword occurrence to be included was set at two (2).

Results
Te fndings from this study are presented in this section refecting (i) growth and trends in MNC research based on publication output, sources, and citations; (ii) productive authors, afliations, and social networks; and (iii) thematic focus of MNC research.

Growth and Trends of Missed Nursing Care (MNC)
Research. Te fndings on annual scientifc production of MNC are presented in this section. Table 2 presents the descriptive information about the documents retrieved including main data information, document type, and authors' collaboration. Te overall documents retrieved (276) included articles and review papers. A total of 772 authors were identifed, with 1391 author appearances. Tere were six authors of single-authored documents and 766 authors of multiauthored documents. Tere were 5.04 co-authorship per documents and 2.86 collaboration indexes between authors.
In Figure 2, the publication trend on MNC in Scopus database is presented from inception [6] through to 20 th February 2022. Te oldest article using the terminology MNC was published in 2006 [6]. Since then, annual production increased steadily, then an exponential increase in the last six years. Although the number of publications between 2006 and 2010 fuctuated, between 2011 and 2021, MNC publications have seen signifcant increase suggesting a strong research interest in the feld. Signifcantly, the number of annual scientifc production of publications leaped from 18 in 2015 to 62 in 2020 suggesting a growing trend in the area.
Te analysis also presents results of the top 20 sources that published articles in the domain of MNC based on the data extracted from Scopus database. Te fndings from Figure 3 indicate that the Journal of Advanced Nursing remain the topmost publication source for MNC research. Tis is followed by Journal of Nursing Management, International Journal of Nursing Studies, Journal of Clinical Nursing, Journal of Nursing Care Quality, Journal of Nursing Administration, Nursing Open, BMC Nursing, BMJ Quality and Safety, and International Nursing Reviews and Collegian. Overall, MNC studies have been published in reputable nursing research journals and the 20 most productive journals list is shown in Figure 3. In addition, Table 3 highlights the top 20 most cited sources.
Further analysis of this section investigated global citations of published documents. In this citation analysis, from 2006 to February 2022, the results of the 20 most cited documents alongside their total citations, total citations per year, and normalised total citations are shown in Table 3. Te most cited paper was the study published by Ball and colleagues, recording total citations of 337 (33.7 citations per year) in BMJ Quality and Safety [33]. Te authors of the topmost cited paper used cross-sectional survey to investigate the nature, prevalence, and associated factors of missed patient care in English National Health hospitals. Te study formed part of the many projects led by the international Nurse Forecasting (RN4CAST) group. Te next most cited papers was the frst MNC qualitative study by Kalisch, published in Journal of nursing Care Quality with 330 citations (18.33 citations per year) [6], followed by Jones and colleagues' state of science literature review in International Journal of Nursing Studies with 320 citations (35.56 total citation per year) [13]. According to the normalised citation scores, the review paper by Jones and his team published in 2015 [13] gained the most impact with a normalised score of 5.79 (Table 4). Since MNC currently is expected to occur in health care settings, many researchers studying the missed care phenomenon most likely will review and cite these papers, thus increasing their total citation counts.
Regarding country citations, Table 4 presents the top 20 highly cited countries with USA ranking frst followed by Switzerland, United Kingdom, Australia, and Cyprus among others.  Figure 4. Te lines within Figure 4 represent authorproduction timeline. Te size of the bubble is proportional to number of documents each author produced per year indicating that the bigger the bubble the higher the number of articles. Te intensity of the bubble colour is also proportional to total citations per year for each author. In addition, the frst appearing bubble on the line indicates the frst publication on missed nursing care for each author.   Nursing Forum

Productive Authors, Institutions, Country, and Collabo
Te number of scientifc productions by authors in the feld understudied increased considerably from 2014 which can be due to the increased awareness of this phenomenon and global interest on safe and quality healthcare delivery that meet patient and staf outcomes.
A visualisation map of prolifc authors, author country, and theme of interest in MNC research is shown in Figure 5 and illustrated by a three-feld plot of document contribution by country (on the left column), authors (names of authors in the middle column), and themes (most used author keywords) of MNC research. Te occurrences of the author keywords form themes in this study. In the three-feld plot, the height of the boxes and the thickness of the connecting lines signify the volume of work published. Tus, longer box heights and thicker lines indicate higher volumes of work published. Again, the results show that Switzerland has more author afliations compared to the USA. Te analysis showed that major contributions of research activity  Nursing Forum has been from authors in countries such as Switzerland, USA, Australia, Italy, Cyprus, United Kingdom, and Poland among others. Te topmost theme in the feld of MNC used by the prolifc authors is "missed nursing care" (Figure 5). Other themes that have been used by these scholars include "missed care," "nursing," "unfnished nursing care," "patient safety," "care left undone," "care rationing," and "quality of care." Again, the analysis showed that themes such as "teamwork," "patient outcomes," "nurse stafng," "work environment," and "job satisfaction" and how they relate to MNC have not seen signifcant global contributions on research output in most poor resourced countries. Scientifc production identifes the amount of studies undertaken by researchers in the feld of study within countries and/or continents [18]. In Figure 6, the map illustrates the country research production on MNC. Te blue colour intensity of the shaded country/regions is proportional to the total number of documents produced by that country/region. Te deeper the colour, the higher the number of published documents in the feld. Deep blue shades represent increased number of research publications in countries such as USA, Australia, and Switzerland.
Regarding the analysis of institutions and document productions, the results of top 20 most relevant institutions ( In respect to co-authorship and social collaboration analysis, this study examined the social structure of MNC research in the bibliometric R-package [18]. Tis type of network shows the relationship or existing collaboration between two or more authors, institutions, or countries. In this study, the collaboration network map between authors and countries is shown in Figures 7 and 8. Figure 7 illustrates the names of authors written in the boxes, the bigger the size of the box, the wider the collaboration network. Te lines connecting the authors represent the strength of collaboration. Te thicker the line, the stronger/wider the network (contributing to increased scientifc production among authors). In addition, there are networks within networks such as Tschannen D. and Lee K.H. all connected to Kalisch B.J. Te results show that scholars including Kalisch B.J., Ausserhofer D., Shubert M., Willis E., Papastavrous E., Palese A., Zelenikova R., Simon M., and Grifths P. among others have established networks with other signifcant authors (Figure 7).
Although the scholars are actively contributing to research in MNC, Figure 8 shows that countries such as Philippines and Oman are in isolation with no collaboration network. However, a well-established collaboration network exists between USA, Switzerland, Italy, United Kingdom, Australia, and New Zealand among other networks as presented in Figure 8 which maps country collaborations and social

Tematic Focus of the Field of Missed Nursing Care.
In this section, research publications on MNC were investigated to identify themes that dominate the feld. Keyword analysis was conducted to identify yearly growth and cumulative occurrences of the keywords in the area studied [18]. Te researchers analysed co-occurrence networks and visualised the word cloud and lastly trending topics in the area. Song and colleagues [34] highlighted that authors keyword analysis in published documents is an essential tool for examining trend topics and authors study focus. In Figure 9, a visualisation of the word cloud shows frequently used keywords in MNC publications. Tese fndings suggest that, frequently used keywords include "unfnished nursing  Nursing Forum care," "care left undone," "patient safety," and "quality of care." In addition, the co-occurrence network analysis was investigated to further gain insight in MNC. Co-occurrence analysis presents links between keywords in existing literature, thereby providing in-depth knowledge in the domain researched. Tis study identifed keywords as shown in the word cloud in Figure 9. In Figure 10, the authors went further to identify the link between keywords highlighting signifcant keywords and their strong collaboration with other keywords. Te thickness of the line (Figure 10) indicates the strength of association between keywords. Hence, the thicker the lines, the stronger the association. Absence of lines connecting keywords indicate that no relationships exist among keywords. Te analysis of trend topics on published studies shows the rise and fall in popularity of trending topics. In Figure 11, the size of the nodes (small to big) represents the amount of research publications that have used the topic or term in a specifed year. Identifying emerging research topics in MNC which is a rapidly growing feld in nursing may provide valuable insights into the "what," "how," and "why" this phenomenon occurs. Likewise, identifying fading MNC research topics can provide understanding of the intellectual structure of this domain. Hence, the analysis of annual trends of MNC research topics is as shown in Figure 11. Te results show signifcant increases in MNC research topics such as "pandemic," "workforce," "systematic review," "practice guidelines," "COVID-19," "patient safety," "job satisfaction," "controlled study," and "qualitative research" within the last two years. Overall, most of the articles analysed have used trend topics such as cross-sectional study, questionnaire, and nursing staf. Tis attests to the diferences in conceptual models and tools used in measuring MNC globally.
Te thematic map analysis in this study aimed at gaining insight into current status of the feld of MNC and what future research holds. Tis type of analysis is useful in providing knowledge in MNC to researchers, health care systems, and policy makers regarding the potential for development of themes for future research in the feld of MNC [18,35,36]. In thematic analysis, clusters of author keywords  and interconnections between the keywords are obtained. Te obtained themes are categorised by "density" and "centrality" which measure how less or well developed or signifcant topics are [36]. Te vertical axis represents density while the horizontal axis represents centrality. Te latter measures the degree of association among themes and the former measures cohesiveness or interconnections among nodes. Figure 12 presents the thematic map of MNC divided in four sections on the map. Tese sections contain motor or driving themes, basic or underlying themes, emerging or declining themes, and niche or specialised themes. Te fndings from this thematic analysis suggest that niche themes such as "adverse events," "emergency department," "medical units," "neonatal intensive care units," "patient safety," "health resources," "failure to maintain," and "organisation culture" are undeveloped research topics in the feld of MNC in diferent patient populations. For example, prospective researchers can be guided by questions such as the following: (1) what is the relationship between MNC and adverse events such as patient falls, medication errors, or pressure ulcers in acute, community, and nonacute healthcare settings? (2) To what extent those MNC infuence patient safety in diferent healthcare settings? (3) Te impact of failure to maintain fundamental nursing care such as patient mobility, communication, feeding, or care of the skin. Tese studies can be examined in specialised hospital units to ascertain the impact of MNC on patient safety. In addition, motor or driving themes identifed in this study include "unfnished care," "rationing," and "psychometrics." Tis fnding suggests that several studies conducted in this domain have used varying psychometric tools and terminologies to measure MNC as highlighted in a state of science review by Jones et al. [13]. Tis is confrmed by the display of terms such as "care left undone," "missed nursing care," and "unfnished nursing care" within the basic or underlying themes in the map. Emerging or declining themes identifed include "care rationing," "implicit rationing," and "rationed care." Since the feld of MNC is still emerging, these themes are likely to rise or decline depending on prospective authors' choice of conceptualisation of MNC and/or terminology.    Figure 11: Trend topics over time.

Discussion
Bibliometric analysis of scientifc research output enables readers to understand the history and development of a research area [18]. Te purpose of this study was to give a bibliometric overview of research output on MNC. Te timing of this study is vital for at least three reasons. First, several international scholars are preparing policy directions to control MNC [37]. Next, the research awareness of MNC in healthcare systems is increasing globally, and thirdly, the outcomes of this phenomenon can have serious implications on patients [38]. Te signifcance of MNC and associated nurse-patient outcomes in the healthcare setting was evident in this bibliometric analysis. Tis analysis showed a noticeable increase in MNC research production and citations. Several reasons such as the signifcant prevalence of MNC [13] and most likely researchers motivated by the search for measures to reduce the occurrence of MNC could be cited for this observation. Tis analysis showed that the USA had extensively investigated missed care and was also the topmost cited country. In addition, countries such as Switzerland, Australia, Italy, and the United Kingdom amongst others have explored MNC. Tis fnding may be due to the large amount of funds invested in MNC research in these countries. In addition, the existence of well-established social networks among authors in these countries and increased number of their publications indicate that collaboration has become the preferred method to conduct scientifc research and reduce the high burden of MNC [7,39]. On the whole, other countries, especially low-and middle-income countries which may have higher burden of MNC [40], should fnd their gaps in MNC research and using the high performing countries as their benchmark, accelerate research on MNC and strive to improve research strength and academic impact in this domain.
Citations help researchers to retrieve the emerging themes, concepts, and future trends for a specifc discipline; the high citations of articles retrieved is indicative of MNC importance, particularly in Anglo countries [37]. Such control cannot be achieved without nurse managers, nurse researchers, consumers, and policy makers' involvement. Addressing the problem on a shift or ward-based redesign using lean production systems to focus on patients, nursing ethics, and time management can be a success story [41] and create an impressive reduction in MNC burden worldwide.
In terms of global citations, the most cited reference was a cross-sectional study conducted by Ball and colleagues [33], followed by a qualitative study by Kalisch [6], and then, a state of the science review by Jones et al. [13]. In addition, surveys conducted by experts on behalf of the Registered Nurse Forecast (RN4CAST) consortium [42] and Schubert and his colleagues [43] are all in the top most cited references. Te most cited founding contributions have allowed the development of research in this feld using varying terminology-specifc tools aimed at providing further 14 Nursing Forum understanding to MNC and implementing innovation [14,17,33,38,42,[44][45][46][47][48][49][50][51][52].
While the global scientifc output maps an image of country scientifc production, there is considerable need for research in Sub-Saharan Africa where many low-income countries are located hence the potential for more MNC [53]. In addition, such countries and their institutions can beneft from international collaboration to study the amount of MNC and contributing factors and compare its occurrence to that of developed countries. Again, analysis of institutions and afliations showed little involvement and collaboration from African institutions. Te growth in the feld of MNC in this region is vital and can promote awareness of this phenomenon leading to in-depth scientifc exploration of what care gets missed and how it impacts patients living in low-income countries.
Research focusing on MNC has an important place in terms of healthcare organisations. Te results from this study also showed the oldest publications dated from 2006 following a growing interest in the area. Te annual growth rate increased by 600% in 2009, tripled in 2015 and increased exponentially from 2018. Tus, it is anticipated that annual scientifc output in this domain will continue to rise. Whilst some MNC articles are not found in open access journals, it is hypothesized that MNC articles will likely receive more citations if published in open access journals to be easily accessible to researchers in low-and middle-income countries.
Analysis of trending topics showed current interest in research on MNC and COVID-19 pandemic. Te growth of research in this area can evidently promote scientifc exploration into what factors contribute to or worsen MNC in pandemics and the impact on nurse-patient outcomes. Results on keyword analysis showed that the most active author keyword used in the retrieved articles was "missed nursing care." Tis interest in the term MNC is likely motivated by the quest for the objective measurement of this phenomenon across countries [11]. In addition, thematic map analysis of authors keywords provided insight into four themes of various words and phrases that have been used over time (such as missed nursing care, unfnished nursing care, patient care, and quality of care) as well as emerging (such as emergency department and primary health care).
Tis study is the frst to analyse MNC using bibliometric method. However, the authors acknowledge that the present study has some limitations that need to be addressed. Te main limitation was the use of one database (Scopus) for data collection. Te authors selected this database because it ensures a wide range of high-quality peer-reviewed journals [29]. Although the authors did their best to use all relevant keywords in the feld of MNC, the possibility of a limited false positive or negative remain a possibility. Again, potential bias exists in terms of sources including publication and language bias. Future researchers can reduce this bias by adding languages other than English with interpretations in search query. In addition, the researchers acknowledge that there are some recent published papers in this domain, which have not yet accumulated several citations as the seminal in the feld. Notwithstanding, this study provides insight into trends in scientifc production of MNC literature and shows gaps in research in low-income countries. Investigating the concept of MNC and how it impacts lowincome countries and the nexus between MNC and COVID-19 are important next steps towards evident based research in this domain.

Conclusions
Tis research applied bibliometric approach to quantitatively analyse available published studies on MNC using the biblioshiny, a bibliometrix app in R software package. Using this analytical method, data retrieved from Scopus were analysed and mapped. Te bibliometric analysis showed that since its inception, MNC research has increased rapidly spreading from USA to parts of Europe and in several countries with majority of these scientifc papers occurring in the last fve years. Diferent terms have been used to refer to MNC in these papers (such as missed care, rationing of nursing care, unfnished care, care left undone, implicit rationing, and errors of omission) [39,54]. Despite this, extent of impact of COVID-19 on MNC research remains elusive.
In addition, the country scientifc production map showed limited research in low-income countries highlighting the opportunity for further research and institutional collaboration to support and improve research in these regions. Also, it is suggested that healthcare systems, authors, and policy makers should invest more in MNC research in relation to adverse events and specifc care missed (such as medication, feeding, skin care, communication and turning) as this study shows that they are potential topics. Finally, given the exponential growth of research in MNC, this research provides valuable insight to current trending topics and themes useful for the development of research questions in clinical settings to investigate MNC and provide further interventions to reduce this phenomenon globally.

Abbreviations
MNC: Missed nursing care.

Data Availability
Te data and materials used to support the study are available from the corresponding author upon request.

Conflicts of Interest
Te authors declare that they have no conficts of interest.

Authors' Contributions
AAS contributed to the study conception, data collection, and drafting of the manuscript. DA, LG, and ATB contributed to study conception, editing, and approval of this research manuscript. Te fnal manuscript was read and approved by all authors.
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