Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Nursing care omissions occur when nurses are unable, due to time, staffing, or resource constraints, to complete essential tasks needed for patient safety and quality of care. These omissions are linked to higher risks of medication errors, infections, falls, and even mortality. While this phenomenon has been studied in urban hospitals, there is no validated tool to measure it in rural emergency departments, where resources are often scarce and patients face greater risks. This study will develop and validate a bilingual (French/English) instrument, called the Nursing Omission Measurement in Emergency Tool (NURSOMIT). In the first phase, items will be generated from literature and professional standards, reviewed through focus groups with rural emergency nurses across Canada, and refined using a Delphi process with experts, followed by individual cognitive interviews. In the second phase, a national survey of approximately 1,000 rural emergency nurses will be conducted to document the prevalence and characteristics of nursing care omissions, and to test the tool's psychometric properties. By linking nursing care omissions to workload, work environment, and perceived patient safety, this research will provide the first reliable evidence on this understudied issue in rural Canada. Findings will guide healthcare managers, policymakers, and educators in developing strategies such as training, staffing policies, and targeted interventions to improve patient safety and support rural nurses. Ultimately, this work aims to strengthen the quality and equity of emergency care in rural and remote communities across Canada