AIM: To evaluate frequencies, types of, and reasons for missed nursing care during the COVID-19 pandemic at inpatient wards in a highly specialized university hospital.

BACKGROUND: Registered nurse/patient ratio and nursing competence is known to affect patient outcomes. The first wave of the COVID-19 pandemic entailed novel ways for staffing to meet the expected increased acute care demand, which potentially could impact on quality of care.

METHODS: A comparative cross-sectional study was conducted, using the MISSCARE Survey. A sample of nursing staff during the first wave of the COVID-19 pandemic (n=130) was compared with a reference sample (n=157).

RESULTS: Few differences between samples concerning elements of missed care, and no significant differences concerning reasons for missed care were found. Most participants perceived the quality of care and the patient safety to be good.

CONCLUSION: The results may be explained by three factors: maintained registered nurse/patient ratio, patients' dependency levels and that nursing managers could maintain the staffing needs with a sufficient skill mix.

IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers impact on the occurrence of MNC; to provide a sufficient registered nurse/patient ratio and skill mix when staffing. They play an important role in anticipatory planning, and during infectious diseases outbreaks.