Missed nursing care is inescapable and can result from several factors, subsequently affecting the healthcare system, nurses, and patients. Maintaining and improving nursing care quality and patient safety is a major challenge for nursing managers.

The main goal of this study was exploring factors affecting missed nursing care from the perspective of nursing managers.

The participants in this qualitative study were 10 nursing managers. The data were collected at a university hospital in Portugal through individual face-to-face interviews using an interview guide and focus group discussions. The data were analysed using a content analysis following Bardin’s method.

The findings of this study present the concept of missed nursing care from nursing managers’ outlook and the outcomes of missed care, and indicate that factors affecting missed care are broadly determined by system structure, contextual factors, barriers to reporting missed care, and outcomes of missed care.

Efforts to foster a supportive work environment, improve the relationship between nurses and nursing managers, and create professional and organizational commitment are examples of important actions that could reduce the incidence of missed nursing care.