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Antoszewska A, Gutysz-Wojnicka A. Rationing nursing care and organizational factors in intensive care units. PLoS One 2024; 19:e0306313. [PMID: 39052619 PMCID: PMC11271898 DOI: 10.1371/journal.pone.0306313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 06/16/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Rationing nursing care is a term that applies to various aspects of the required patient care that are omitted or their performance is delayed. AIM This study aimed to identify the extent of rationing of nursing care in intensive care units (ICUs) in different types of hospitals and determine the relationship between rationing of nursing care and hospital and staff characteristics. METHODS This quantitative, cross-sectional, multicenter study was performed. The sample comprised 226 nurses working in ICUs in a North-East part of Poland. The Polish version of the PRINCA questionnaire methods was applied. The survey was conducted between 15 January and 31 May 2023. RESULTS There were statistically significant differences between rationing of nursing care in university/provincial hospitals and district hospitals t = 6.92 p<0.001. In provincial and university hospitals, nursing care is often omitted, leading to a lower perceived quality of nursing care (t = -3.0 p = 0.003). This is further compounded by the fact that nursing care is more likely to be rationed in units with a larger number of beds. The level of rationing of nursing care was significantly correlated with the perceived work quality and job satisfaction in both types of hospitals. The most frequently omitted aspects of nursing care included providing emotional support (university/provincial 1.27 vs. district 0.89), patient and family education (1.11 vs. 0.74), communication with external entities (1.11 vs. 0.84), and observing safe patient-handling practices (1.01 vs. 0.99). CONCLUSION The type of hospital and organizational factors influence the rationing of nursing care. Improvements in working conditions can improve nursing care quality in ICUs.
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Affiliation(s)
- Anna Antoszewska
- Department of Nursing, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
| | - Aleksandra Gutysz-Wojnicka
- Department of Nursing, School of Public Health, Collegium Medicum, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland
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Kohanová D, Zrubcová D, Bartoníčková D, Solgajová A. Unmet care needs in psychiatric healthcare context: A systematized literature review. J Psychiatr Ment Health Nurs 2024. [PMID: 39016194 DOI: 10.1111/jpm.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 06/11/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
WHAT IS KNOWN ON THE SUBJECT Missed, rationed or unfinished nursing care represents a global problem that jeopardizes the provision of quality and safe care. This phenomenon is frequently observed in adult, paediatric and child healthcare facilities and various care units. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE The findings of this review contribute valuable information to inform evidence-based practices, foster organizational improvements and ultimately optimize the overall quality of care in psychiatric healthcare settings. In addition, the review illuminates the far-reaching consequences of care on both patient and nurse outcomes, emphasizing the urgent need for tailored strategies to mitigate these effects. WHAT ARE THE IMPLICATIONS FOR PRACTICE Based on the synthesis of the literature, a thorough and continuous assessment of patient care needs in the physical, psychological and social domains is needed, primarily utilizing standardized instruments designed for psychiatric settings to ensure a comprehensive understanding of unmet needs. Based on identified unmet needs, nurses should develop individualized care plans and tailor interventions to address them. In addition, nurse managers must adopt and implement regular monitoring mechanisms to track the prevalence of unmet care needs and at the same time establish reporting systems that capture the proportion of unmet needs, allowing timely interventions and adjustments to care delivery. Lastly, nurse managers must not only emphasize the importance of ethical care practices and dignity-focused interventions but also educate healthcare providers, especially nurses, on the potential threats to patient dignity arising from unmet care needs. ABSTRACT INTRODUCTION: Despite frequent observations of unmet care needs in acute care adult settings, there are a limited number of studies that focus on investigating this phenomenon in the psychiatric setting. AIM To synthesize the existing empirical research on unmet care needs in psychiatric healthcare settings. METHODS The search was carried out in August 2023 in four scientific databases, PubMed, ProQuest, Web of Science and OVID Nursing, based on their institutional availability. The search produced 1129 studies. The search and retrieval process reflected the recommendations of the Preferred Reporting Items for systematic reviews and meta-analyses. RESULTS This review included 14 studies investigating unmet care needs in the psychiatric healthcare setting. Unmet care needs included three domains: physical, psychological and social. The analysis of the factors revealed factors related to the characteristics of the organization, nurse and patient. DISCUSSION The classification of unmet needs provides a comprehensive understanding of the various challenges facing people in psychiatric healthcare settings. IMPLICATION FOR PRACTICE Identified factors that influence the occurrence of unmet care needs will help prevent the occurrence of unmet care needs and timely assessment. The resolution of needs helps to achieve patient and nurse outcomes, increase the quality of care provided and patient satisfaction in a psychiatric healthcare setting.
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Affiliation(s)
- Dominika Kohanová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
| | - Dana Zrubcová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
| | - Daniela Bartoníčková
- Department of Nursing, Faculty of Health Sciences, Palacký University Olomouc, Olomouc, Czechia
| | - Andrea Solgajová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University, Nitra, Slovakia
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Kohanová D, Gurková E, Kirwan M, Žiaková K, Kurucová R. Nursing students' perceptions of unfinished nursing care: A cross-sectional study. Nurse Educ Pract 2024; 76:103942. [PMID: 38522345 DOI: 10.1016/j.nepr.2024.103942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/17/2024] [Accepted: 03/09/2024] [Indexed: 03/26/2024]
Abstract
AIM To investigate the prevalence, patterns and reasons for unfinished nursing care as perceived by nursing students. BACKGROUND Unfinished nursing care (UNC) is a frequently observed phenomenon in the acute care setting. To date, studies have focused primarily on the perspective of nurses or patients, but another important perspective is that of nursing students who provide nursing care in all healthcare settings. DESIGN A descriptive cross-sectional study. METHODS The study included 738 undergraduate nursing students from nine Slovak universities. Data were collected between September 2022 and February 2023 using the Slovak version of the Unfinished Nursing Care Survey tool (UNCS). Data were analyzed using descriptive and inferential statistics. RESULTS The mean composite score of UNCS was 2.48 (SD=0.68). In general, 100% of nursing students reported that nurses missed at least one or more nursing care activities during their last clinical placement. The average number of missed nursing care activities was 11.2 per nurse as perceived by nursing students during their last clinical placement. Nursing students reported that the most frequently omitted nursing care activity was spending time with patients and their caregivers (3.15 ± 1.11; 92.9%). The most frequently reported reason for UNC was an inadequate number of nurses on the ward (4.31 ± 1.01; 98.1%). In the study, reported UNC could be predicted by previous experience in healthcare, previous clinical rotation, number of patients per shift, perceived staff adequacy and outcome expectations (p <0.05). CONCLUSIONS The findings reveal that UNC is a widespread phenomenon and all nursing students report this phenomenon during their clinical placements. Spending time with patients and their caregivers emerged as the most frequently omitted nursing care activity, highlighting the importance of patient-centered care. The primary reason cited for UNC was an inadequate number of nurses, highlighting staffing issues as a significant contributing factor. These findings emphasize the need for targeted interventions to address staff shortages and improve nursing education to prepare students to address UNC in their future practice.
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Affiliation(s)
- Dominika Kohanová
- Department of Nursing, Faculty of Social Sciences and Health Care, Constantine the Philosopher University in Nitra, Slovakia.
| | - Elena Gurková
- Department of Nursing, Faculty of Health Care, University of Prešov, Slovakia
| | - Marcia Kirwan
- School of Nursing, Psychotherapy and Community Health, Dublin City University in Dublin, Ireland.
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
| | - Radka Kurucová
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Slovakia
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Jędrzejczyk M, Guzak B, Czapla M, Ross C, Vellone E, Juzwiszyn J, Chudiak A, Sadowski M, Uchmanowicz I. Rationing of nursing care in Internal Medicine Departments-a cross-sectional study. BMC Nurs 2023; 22:455. [PMID: 38044434 PMCID: PMC10694866 DOI: 10.1186/s12912-023-01617-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/20/2023] [Indexed: 12/05/2023] Open
Abstract
BACKGROUND Implicit rationing of nursing care refers to a situation in which necessary nursing care is not performed to meet all of the patients' needs. PURPOSE To examine the factors influencing the rationing of nursing care, nurses' assessment of the quality of patient care, and their job satisfaction in Internal Medicine Departments. METHODS A cross-sectional descriptive study was undertaken. The study included 1164 nurses working in the Internal Medicine Departments in 8 hospitals (Lower Silesia, Poland). The Perceived Implicit Rationing of Nursing Care instrument was used. RESULTS Respondents rarely ration nursing care, with a mean score of 1.12 (SD = 0.68). The mean score for quality of patient care was 6.99 (SD = 1.92). In contrast, the mean job satisfaction score was 6.07 points (SD = 2.22). The most important predictors of high rates of rationing of nursing care were work experience of 16-20 years (regression parameter: 0.387) and a Bachelor's degree in nursing (regression parameter: 0.139). Nurses' assessment of the quality of patient care ratings were increased by having a Master's degree in nursing (regression parameter: 0.41), and significantly decreased by work experience of 16-20 years (regression parameter: -1.332). Independent predictors of job satisfaction ratings in both univariate and multivariate analysis were Master's degree and long-shift working patterns. CONCLUSION The factors that influence an increased level of nursing care rationing on medical wards are nurse seniority, exceeding 16 years and female gender. Obtaining a Master's degree in nursing indicates improved nurses' assessment of the quality of patient care.
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Affiliation(s)
- Maria Jędrzejczyk
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Beata Guzak
- Center of Postgraduate Education for Nurses and Midwives, Warsaw, Poland
| | - Michał Czapla
- Institute of Heart Diseases, University Hospital, Wroclaw, 50-566, Poland.
- Department of Emergency Medical Service, Wroclaw Medical University, ul. Parkowa 34, Wroclaw, 51-616, Poland.
- Group of Research in Care (GRUPAC), Faculty of Health Science, University of La Rioja, Logroño, 26006, Spain.
| | - Catherine Ross
- The Centre for Cardiovascular Health, School of Health and Social Care, Edinburgh Napier University, Edinburgh, EH11 4BN, UK
| | - Ercole Vellone
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
- Department of Biomedicine and Prevention, University of Roma Tor Vergata, Rome, Italy
| | - Jan Juzwiszyn
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Chudiak
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Mikołaj Sadowski
- Department of Anaesthesiology and Intensive Care, University Hospital, Wrocław, 50-556, Poland
| | - Izabella Uchmanowicz
- Department of Nursing and Obstetrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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Li HQ, Xie P, Huang X, Luo SX. The experience of nurses to reduce implicit rationing of nursing care: a phenomenological study. BMC Nurs 2023; 22:174. [PMID: 37208756 DOI: 10.1186/s12912-023-01334-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/10/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Implicit rationing of nursing care can adversely affect patient safety and the quality of care, and increase nurses' burnout and turnover tendency. Implicit rationing care occurs at the nurse-to-patient level (micro-level), and nurses are direct participants. Therefore, the strategies based on experience of nurses to reduce implicit rationing care have more reference value and promotion significance. The aim of the study is to explore the experience of nurses to reduce implicit rationing care, thereby to provide references for conducting randomized controlled trials to reduce implicit rationing care. METHODS This is a descriptive phenomenological study. Purpose sampling was conducted nationwide. There are 17 nurses were selected and semi-structured in-depth interviews were conducted. The interviews were recorded, transcribed verbatim and analyzed via thematic analysis. RESULTS Our study found that nurses' reported experience of coping with implicit rationing of nursing care contained three aspects: personal, resource, and managerial. Three themes were extracted from the results of the study: (1) improving personal literacy; (2) supplying and optimizing resources and (3) standardizing management mode. The improvement of nurses' own qualities are the prerequisites, the supply and optimization of resources is an effective strategy, and clear scope of work has attracted the attention of nurses. CONCLUSION The experience of dealing with implicit nursing rationing includes many aspects. Nursing managers should be grounded in nurses' perspectives when developing strategies to reduce implicit rationing of nursing care. Promoting the improvement of nurses' skills, improving staffing level and optimizing scheduling mode are promising measures to reduce hidden nursing rationing.
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Affiliation(s)
- Hui Qin Li
- Mental Health Center, West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province, 610041, P.R. China
| | - Peng Xie
- Surgical Anesthesia Center, West China School of Nursing, West China Hospital, Sichuan University, No. 28 Telecom South Street, Chengdu, Sichuan Province, 610041, P.R. China
| | - Xia Huang
- Mental Health Center, West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province, 610041, P.R. China.
| | - Shan Xia Luo
- Mental Health Center, West China School of Nursing, West China Hospital, Sichuan University, No. 37 Guoxue Road, Chengdu, Sichuan Province, 610041, P.R. China.
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O'Donnell C, Markey K, Murphy L, Turner J, Doody O. Cultivating support during COVID-19 through clinical supervision: A discussion article. Nurs Open 2023. [PMID: 37149892 DOI: 10.1002/nop2.1800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/06/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023] Open
Abstract
AIM This article aims to discuss how clinical supervision is an important approach in supporting frontline nurses and students during and post COVID-19 through the lens of the nursing metaparadigms. DESIGN Discussion article. METHODS Discourse of the literature considering the importance of working collaboratively with healthcare and educational organisations in operationalising clinical supervision. RESULTS The evidence base supporting clinical supervision as an effective support strategy for nurses exists, however, its implementation and practice has become sporadic. A resurgence is required to support student's and nurse's during this pandemic. It is timely for nurse educators to creatively engage with clinical partners in supporting clinical supervision to enhance both nurses and students pandemic practice experiences. Clinical supervision is proposed as one strategy to support and guide both nurses and students to develop, strengthen and challenge the effectiveness of their care during COVID-19.
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Affiliation(s)
- Claire O'Donnell
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - Louise Murphy
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
| | - James Turner
- Department of Nursing and Midwifery, College of Health and Life Sciences, Sheffield Hallam University, Sheffield, UK
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland
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Zeleníková R, Jarošová D, Polanská A, Mynaříková E. Implicit rationing of nursing care reported by nurses from different types of hospitals and hospital units. J Clin Nurs 2023. [PMID: 36945137 DOI: 10.1111/jocn.16695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/16/2023] [Accepted: 03/06/2023] [Indexed: 03/23/2023]
Abstract
AIMS AND OBJECTIVES The study aimed to investigate differences in assessing implicit rationing of nursing care by Czech nurses with respect to the type of unit and type of hospital. BACKGROUND Implicit rationing of nursing care may differ across different types of hospitals and hospital units. DESIGN This study used a multicentre cross-sectional study design. METHODS The STROBE checklist for observational cross-sectional studies was followed for reporting of the research study. The sample included 8209 nurses providing direct care to medical and surgical patients in 14 acute care Czech hospitals. The main outcome was implicit rationing of nursing care as measured with a Czech version of the Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument. Data were collected from September 2019 to October 2020. RESULTS The most frequently rationed nursing care activity was timely response to patient or family request/need, followed by emotional or psychological support and adequate supervision of delegated tasks. More implicitly rationed nursing care was reported in medical units. Statistical differences were found in rating 25 items and the PIRNCA total score. Nurses from middle-sized hospitals reported implicitly rationed care more frequently than those from large hospitals. CONCLUSION More rationed care was reported by nurses from medical units and nurses from middle-sized hospitals. Organisational variables (the type of unit and type of hospital) influence the implicit rationing of nursing care in our study. RELEVANCE TO CLINICAL PRACTICE The findings call for nursing managers to pay attention to organisational variables which may affect the implicit rationing of nursing care.
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Affiliation(s)
- Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Darja Jarošová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Andrea Polanská
- Department of Nursing Care, University Hospital Ostrava, Ostrava, Czech Republic
| | - Eva Mynaříková
- Department of Nursing Care, University Hospital Ostrava, Ostrava, Czech Republic
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Jarosz K, Młynarska A. The Impact of Sociodemographic Factors on the Rationing of Nursing Care in Urology Wards. NURSING REPORTS 2023; 13:561-572. [PMID: 36976703 PMCID: PMC10051577 DOI: 10.3390/nursrep13010051] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/13/2023] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The problem of care rationing is widespread all over the world and results from many factors affecting nurses. These factors may result from the environment in which the nurses work, e.g., the atmosphere at work, or may not be related to work, e.g., place of residence. The aim of this study was to examine the impact of sociodemographic factors (place of residence, satisfaction with the financial situation, number of forms of postgraduate education, work system, number of patients per nurse, number of diseases) on care rationing, job satisfaction and quality of nursing care. METHODS The study is a cross-sectional study which includes 130 nurses from all over Poland who work in urology wards. The criteria for inclusion were consent to the examination, practicing the profession of a nurse, work in the urology department and work experience of at least 6 months, regardless of the number of hours worked (full-time/part-time). The study was conducted using the standardized PIRNCA (Perceived Implicit Rationing of Nursing Care) questionnaire. RESULTS The average rationing nursing care was 1.11/3 points which means nursing care was rarely rationed. The average job satisfaction was 5.95/10 points, and the assessment of the quality of patient care was 6.88/10 points, which means a medium level of the job satisfaction and the quality of patient care. The rationing of care was affected by the number of nurse illnesses; job satisfaction was influenced by the place of residence and satisfaction with the financial situation, while the quality of care was not influenced by any of the analyzed factors. CONCLUSIONS The result of care rationing is at a similar level as the results in Poland and abroad. Despite the rare rationing of care, employers should take corrective action, especially in terms of increasing the staff and health prevention of nurses.
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Affiliation(s)
- Katarzyna Jarosz
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, 40-055 Katowice, Poland
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Bahun M, Jeriček Klanšček H. Doživljanje neizvedene zdravstvene nege pri medicinskih sestrah. OBZORNIK ZDRAVSTVENE NEGE 2023. [DOI: 10.14528/snr.2023.57.1.3173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023] Open
Abstract
Uvod: Stiske zaradi zdravstvene nege, ki ostaja zaradi različnih razlogov neizvedena, so pri medicinskih sestrah pogosto spregledane in neprepoznane. Namen integrativnega pregleda literature je pregledati najnovejše raziskave, ki opisujejo, kako se neizvedena zdravstvena nega izraža na duševnem počutju medicinskih sester.Metode: Uporabili smo integrativni pregled literature, izveden v skladu s PRISMA smernicami v podatkovnih bazah PubMed, CINAHL, Wiley, COBISS.SI in Google Učenjak. Potek iskanja in analize literature je prikazan s pomočjo PRISMA diagrama. Zadetke smo razvrstili glede na raven dokazov. Uporabili smo tematsko analizo vsebine.Rezultati: Skupaj je bilo identificiranih 175 in v končno analizo vključenih 11 virov. Identificirano je bilo 96 kod združenih v 4 kategorije: (1) Telesno, duševno in čustveno počutje, (2) Moralno etične dileme, (3) Sprejemanje odločitev pri delu – prilagajanje, (4) Poklicne in osebne vrednote.Diskusija in zaključek: Neizvedena zdravstvena nega je za medicinske sestre pomemben izvor stisk in stresa, saj zaradi neizvajanja vseh potrebnih aktivnosti v zdravstveni negi prihajajo v neskladje s svojimi osebnimi in poklicnimi vrednotami. Naši rezultati dodajajo vsebinski kontekst in boljše razumevanje posledic neizvedene zdravstvene nege pri medicinskih sestrah. Vsakodnevno odločanje, katere aktivnosti bo potrebno izpustiti, vpliva ne samo na slabše počutje, nezadovoljstvo in izgorelost, ampak celo na zapuščanje delovnih mest in poklica.
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Plevová I, Kadlubová L. Standard operating procedure - palliative care. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2023. [DOI: 10.15452/cejnm.2022.13.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2023] Open
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Abdelhadi N, Drach-Zahavy A, Srulovici E. Toward understanding nurses' decisions whether to miss care: A discrete choice experiment. Int J Nurs Stud 2023; 139:104448. [PMID: 36746011 DOI: 10.1016/j.ijnurstu.2023.104448] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023]
Abstract
BACKGROUND Studies of missed nursing care suggest that it results from ward-level, patient-related, and task-type factors, while nurses' decision-making style was scarcely studied. Studying the effect of nurses' decision-preference structures, namely a pattern of joint ward and patient factors, on missed care may also contribute to understanding the phenomenon. OBJECTIVES To examine the relationships between decision-preference structures and missed care and the moderating effects of decision-making styles and task type in these links. DESIGN A discrete choice experiment with a between- and within-participants design. PARTICIPANTS A sample of 387 registered nurses working in acute medical surgical wards in Israel. METHODS Based on the protocol for discrete choice experiments, a survey was developed to assess the decision-preference structure, considering five factors: overload, presence of head nurse, clinical complexity, difficult patient, and presence of relatives. Participants were randomly assigned to four task-type conditions and completed a survey regarding their task. Decision-making style was assessed using a validated questionnaire. RESULTS Extensive workload (b = -0.46; p = 0.001), difficult patient (b = -0.20; p = 0.001), and patient clinical complexity (b = -0.10; p = 0.006) were negatively linked to the probability of missed care. The interaction between workload and task type (b = 0.252; p = 0.017) indicated that the probability of missed care under extensive compared with regular workload was lowest for developing a discharge plan and highest for providing emotional support. The interaction of patient complexity and task type (b = 0.230; p = 0.013) indicated that the probability of missed care in developing a discharge plan and medication administration was lower for patients having high compared with low clinical complexity. The interaction between difficult patient and task type (b = -0.219; p = 0.044) indicated that the probability of missed care in emotional support, developing a discharge plan, and patient's mobility was lower for difficult than for non-difficult patients. Finally, the interaction between workload and decision-making style (b = -0.48; p = 0.001) indicated that the probability of missed care under heavy compared with regular workloads was lower for the dual-preference or the dominantly intuitive styles. CONCLUSIONS This design enabled examining the prioritizing processes nurses use when deciding about whether to miss care. The likelihood of missing more in structured tasks is lower under a heavy overload and when patients appear difficult or clinically complex. Dual-preference styles or dominantly intuitive styles are more suitable for the routine high workload.
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Affiliation(s)
- Nasra Abdelhadi
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
| | - Anat Drach-Zahavy
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
| | - Einav Srulovici
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel.
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Schneider-Matyka D, Świątoniowska-Lonc N, Polański J, Szkup M, Grochans E, Jankowska-Polańska B. Assessment of The Effect of Stress, Sociodemographic Variables and Work-Related Factors on Rationing of Nursing Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2414. [PMID: 36767779 PMCID: PMC9915080 DOI: 10.3390/ijerph20032414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 01/25/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
(1) Rationing of nursing care is withholding, limiting or not fulfilling the necessary nursing activities for patients. It may have a negative effect on patient safety and the quality of care. The aim of the present paper is the assessment of the effect of stress on the rationing of nursing care. (2) The current research has a cross-sectional, observational design. The study sample comprised 567 nurses. The following questionnaires were used in the study PIRNCA and PSS-10. (3) It was demonstrated that nurses with a high level of perceived stress rationed nursing care to a greater extent and showed lower assessment of nursing care and lower job satisfaction in comparison with nurses with average and low levels of perceived stress. (4) 1. Stress in nurses has a negative effect on rationing of nursing care and job satisfaction. It is recommended that actions aimed at developing effective stress coping skills be implemented as early as at the stage of training to become a nurse. 2. Factors such as marital status, sex, form of employment, place of employment and the level of professional burnout syndrome may have an influence on the level of experienced stress. In turn, the level of experienced stress, marital status, education, place of work as well as the place of residence may have an effect on rationing of nursing care and, consequently, affect the quality of care.
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Affiliation(s)
- Daria Schneider-Matyka
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | | | - Jacek Polański
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 213 Borowska Street, 50-556 Wrocław, Poland
| | - Małgorzata Szkup
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Pomeranian Medical University in Szczecin, Żołnierska 48, 71-210 Szczecin, Poland
| | - Beata Jankowska-Polańska
- Center for Research and Innovation, 4th Military Hospital, 5 Weigla Street, 50-981 Wrocław, Poland
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Senek M, Robertson S, Taylor B, Wood E, King R, Ryan T. Consequences of understaffing on type of missed community care- a cross-sectional study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2022; 4:100075. [PMID: 38745608 PMCID: PMC11080403 DOI: 10.1016/j.ijnsa.2022.100075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/30/2021] [Accepted: 03/08/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Resource cuts to primary and community care in combination with a decline of those working in community settings is compromising quality of care and patient safety in the UK. It is reported that the negative consequences of understaffing and underfunding have worsened due to the COVID-19 pandemic. OBJECTIVE This is a cross-sectional study that aimed to examine short and long-term District and Community nursing working conditions. The objectives were to assess the prevalence of understaffing and missed care and the relationship between individual and organisational factors and their association with missed care outcome. We further explored the relationship between additional caseload, staffing levels and missed care. METHODS We developed a questionnaire based on the validated MISSCARE survey. Outcome measures were, number of vacancies per team, staffing levels, reported incidence of missed care, type of missed care, length of shift and overtime. RESULTS Only 23% of teams reported having no vacancies. The mean staffing ratio was reported at 60%, including agency/bank staff (0.59±1.5). Prevalence of missed care was relatively high (60%≈). The distribution of types of missed care was spread evenly across all types of nursing care. A backward stepwise regression analysis showed that the Proportion of Permanent staff capacity OR=7.9 (95% CI 0.09-0.65), Active Caseload Size OR= 5.5 (95% CI: 1.0 - 1.003), Number of RNs on the team (OR 4.8 (95% CI:1.003-1.058) and Amount of Overtime worked (OR= 3.9 (95% CI:0.98-1.0) variable are statistically significant predictors of missed care. The analysis showed an increase in additional allocated cases per RN as the permanent staff proportion decreased to 70%, at which point the likelihood of reported Missed Care outcome peaks. CONCLUSION The compromised quality of care related to human resources and organisational aspects of the nursing process. Where RNs worked longer hours to make up for the backlog of cases, the prevalence of missed care was more likely. Longer working hours in the community increased the risk of compromised care and sub-optimal patient care. The aspects of the nursing process identified as 'missed' related to The World Health Organisation's three main pillars of community nursing (health promotion, patient education and screening). As such, significant components of the two first pillars are, according to these data, being undermined.
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Affiliation(s)
- Michaela Senek
- The University of Sheffield, Health Sciences School, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom
| | - Steven Robertson
- The University of Sheffield, Health Sciences School, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom
| | - Bethany Taylor
- The University of Sheffield, Health Sciences School, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom
| | - Emily Wood
- The University of Sheffield, Health Sciences School, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom
| | - Rachel King
- The University of Sheffield, Health Sciences School, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom
| | - Tony Ryan
- The University of Sheffield, Health Sciences School, 387 Glossop Road, Sheffield S10 2HQ, United Kingdom
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Examining the reasons for missed nursing care from the viewpoints of nurses in public, private, and university hospitals in Jordan: A cross-sectional research. Collegian 2022. [DOI: 10.1016/j.colegn.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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15
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Rationing Care, Job Satisfaction, Fatigue and the Level of Professional Burnout of Nurses in Urology Departments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148625. [PMID: 35886482 PMCID: PMC9321796 DOI: 10.3390/ijerph19148625] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 07/10/2022] [Accepted: 07/13/2022] [Indexed: 11/17/2022]
Abstract
The problem of rationing nursing care is common and present all over the world, which is a direct threat to the health and life of patients. The aim of the study was to assess the level of rationing care, fatigue, job satisfaction and occupational burnout and to assess the relationship between them and age, length of service and the number of jobs. A survey was performed among 130 Polish nurses in urology departments using the following questionnaires: Link Burnout Questionnaire, Job Satisfaction Scale, Nursing Care Rationing Scale and Modified Fatigue Impact Scale. Nursing care is rarely rationed-1.11 points; the experience of fatigue ranges between sometimes and often-52.58 points; and job satisfaction is at an average level-17.23 points. The level of rationing nursing care in urology departments is similar to that in other departments. This requires minor changes to the work of nurses to reduce the workload. Employers should develop implementation programs for young workers in order to avoid burnout and also invest in factors increasing nurses' satisfaction, such as the atmosphere at work.
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Determinants Affecting the Rationing of Nursing Care and Professional Burnout among Oncology Nurses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127180. [PMID: 35742428 PMCID: PMC9222562 DOI: 10.3390/ijerph19127180] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 01/02/2023]
Abstract
Rationing of nursing care (RNC) is characterized by the omission of any aspect of the required patient care, resulting in incomplete or delayed nursing activities. Oncology nurses are exposed to a very high psychological burden, which can lead to the development of professional burnout syndrome (PBS). The level of PBS might be related to life and job satisfaction. This study aimed to identify determinants affecting RNC and reveal the relationship between RNC, life and job satisfaction, and the PBS levels among oncology nurses. The sample was a hundred oncology nurses from four hospitals in Poland with a mean age of 43.26 ± 10.69 years. The study was conducted from March 2019 to February 2020. The self-administered sociodemographic questionnaire and validated scales determining missed nursing care, job and life satisfaction, and life orientation were used: Basel Extent of Rationing of Nursing Care-Revised (BERNCA-R), Satisfaction with Job Scale (SWJS), Satisfaction with Life Scale (SWLS), Life Orientation Test-Revised (LOT-R), and Maslach Burnout Inventory (MBI). The mean BERNCA score was 1.55 ± 0.15, which indicates the frequency of RNC was between “never” and “rarely”. The mean SWJS score was 11.71 ± 5.97, which showed that nurses were “dissatisfied” and “rather dissatisfied” with their job. A low SWLS score was reported by 59% of nurses, which means that more than half of the respondents described their life satisfaction as low. In LOT-R, 66% of nurses reported pessimistic and 31% neutral life orientation. The mean overall MBI score was 49.27 ± 19.76 points (EE = 63.56 ± 25.37, DEP = 37.2 ± 24.95, and lack of PA = 47.05 ± 22.04), which means that half of the nurses perceived burnout and half did not. Additionally, the higher the job satisfaction (SWJS), the more frequent the RNC (BERNCA) (p < 0.05). The greater the EE, the stronger the sense of lack of PA, and the higher the PBS (MBI) level, the less frequent the RNC (BERNCA). In conclusion, there is a phenomenon of omission of some aspects of care among oncology nurses, but it is not frequent and concerns areas not directly related to therapeutic tasks, but requiring effort and not resulting in quick noticeable effects. It depends only little on life satisfaction and more on job satisfaction and PBS level. The results may indicate the professionalism of Polish nurses, their responsibility towards their patients’ life and health, and the sense of mission that enables them to perform their duties regardless of the external and internal difficulties. The presence of the PBS phenomenon in oncology nurses highlights the need for continued research in this area.
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O' Donnell C, Markey K, O'Brien B. Guiding Nurse Managers in Supporting Nurses in Dealing with the Ethical Challenge of Caring. J Nurs Manag 2022; 30:2357-2361. [PMID: 35506521 PMCID: PMC10084075 DOI: 10.1111/jonm.13658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 04/29/2022] [Indexed: 11/28/2022]
Abstract
AIM(S) To present the theory of resigning in supporting nurse managers in dealing with nurses' ethical challenge of caring. BACKGROUND In a COVID-19 era, nurses continue to be ethically challenged in maintaining safe patient care. Nurse Managers play a critical role supporting staff in responding to the complexities of working in, under resourced environments. EVALUATION Literature suggests care delivery is compromised in times of staff shortages, lack of resources and increased demands on nurses. Examining caring behaviours through the theoretical lens of the theory of resigning enables nurse managers to understand nurses' behaviours, cultivating supportive working environments. KEY ISSUE(S) Nurses strive to provide quality, safe care but are sometimes unable to give the level or type of care they wish, due to the presence of constraints. CONCLUSION(S) This paper provides suggestions for nurse managers in dealing with nurses' daily moral distress arising from working within constraints while still trying to provide safe care. IMPLICATIONS FOR NURSING MANAGEMENT Nurse Managers need to develop greater insights into the ethical dilemmas nurses experience and support them to temporarily realign beliefs and values, while continuing to work within constraints. Understanding ethical dilemmas of prioritising care is required to address and manage this concern.
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Affiliation(s)
- Claire O' Donnell
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Ireland
| | - Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Ireland
| | - Brid O'Brien
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Ireland
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Vujanić J, Mikšić Š, Barać I, Včev A, Lovrić R. Patients' and Nurses' Perceptions of Importance of Caring Nurse-Patient Interactions: Do They Differ? Healthcare (Basel) 2022; 10:554. [PMID: 35327032 PMCID: PMC8956000 DOI: 10.3390/healthcare10030554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/09/2022] [Accepted: 03/15/2022] [Indexed: 12/03/2022] Open
Abstract
Nurse−patient interaction is a professional and therapeutic relationship created to enable nurses to assess, plan, and deliver health care aimed at meeting patients’ basic human needs. The main aim of this study was to identify distinctive characteristics and differences in perceptions between patients and nurses related to the importance of caring interactions and to examine the contribution of independent variables in explaining their perceptions. A total of 446 respondents were included in the research (291 patients and 155 registered nurses). Data were collected using the translated and standardized 70-item version of the Caring Nurse−Patient Interactions Scale (CNPI-70) version for patients and version for nurses. According to the overall CNPI-70 scale, there was a significant difference in patients’ and nurses’ perception (p < 0.001). Patients assessed caring nurse−patient interactions significantly higher (4.39) than nurses (4.16). Additionally, nurses assessed all subscales significantly lower than patients who assessed them high (p < 0.05), except for the subscales for “environment” (p = 0.123) and “spirituality” (p = 0.132). Independent variables did not contribute to an explanation of respondents’ perceptions. Providing quality physical assistance in meeting human needs through effective communication and teaching is crucial for promoting a holistic patient approach, improving psychosocial support and nurse−patient interaction, and attaining greater satisfaction with health care provided without additional financial investments.
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Affiliation(s)
- Jasenka Vujanić
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.V.); (Š.M.); (I.B.); (A.V.)
| | - Štefica Mikšić
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.V.); (Š.M.); (I.B.); (A.V.)
| | - Ivana Barać
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.V.); (Š.M.); (I.B.); (A.V.)
| | - Aleksandar Včev
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.V.); (Š.M.); (I.B.); (A.V.)
- Department of Internal Medicine, University Hospital Centre Osijek, 31000 Osijek, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Robert Lovrić
- Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia; (J.V.); (Š.M.); (I.B.); (A.V.)
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Strategies for Reducing Rationed Nursing Care: Qualitative Secondary Analysis. ACTA MEDICA MARTINIANA 2021. [DOI: 10.2478/acm-2021-0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Introduction: Nursing students spend a meaningful part of their professional training in clinical practice. However, to a significant extent, they actively or passively contribute to the occurrence of rationed nursing care in clinical practice. Therefore, it is crucial that they actively participate in implementing targeted strategies to reduce rationed nursing care.
Aim: To explore nursing students′ experience with strategies focusing on the reduction of rationed nursing care.
Methods: We chose a qualitative secondary analysis to address unpublished data related to nursing students′ experience with strategies focusing on reducing rationed nursing care. The data included a set comprising of 148 pages with transcribed verbatim of 18 semi-structured interviews. The data were analyzed by a deductive content analysis.
Results: Based on the outcome of the secondary analysis, we identified two meaningful categories: Preventive strategies in clinical practice and Importance and meaning of preventive strategies. These two categories reflected nursing students′ experience with targeted strategies to reduce rationed nursing care in clinical practice.
Conclusion: Proposal and subsequent implementation of preventive strategies are essential for reducing rationed nursing care phenomenon from the clinical practice environment. The perspective of nursing students is vital due to their intensive perception of rationed nursing care in clinical practice. Students may identify areas that work-place staff may not explicitly focus on and consider important but jeopardize the quality of care or patient safety.
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Self-assessment of Rationing and Quality of Nursing Care. J Nurs Care Qual 2021; 37:E48-E53. [PMID: 34775421 DOI: 10.1097/ncq.0000000000000607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Nursing care rationing has been a widespread problem in everyday nursing practice for many years. PURPOSE The aim of this research study was to assess the prevalence of care rationing among nurses working in Poland. METHODS The study was conducted among a population of 1310 nurses. To examine the dependencies between the sociodemographics and unfinished nursing care, the Polish adaptation of the Perceived Implicit Rationing of Nursing Care questionnaire and an investigator-developed questionnaire were used. RESULTS The mean level of missed care was 1.16 (SD = 0.7). The significant predictors of care rationing were associated with the quality of patient care (βstd = -.43, P < .001) and general work satisfaction (βstd = -.15, P < .001). CONCLUSIONS Job satisfaction and the quality of nursing care should be constantly monitored as these factors are significantly associated with the levels of care rationing.
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Kołtuniuk A, Witczak I, Młynarska A, Czajor K, Uchmanowicz I. Satisfaction With Life, Satisfaction With Job, and the Level of Care Rationing Among Polish Nurses-A Cross-Sectional Study. Front Psychol 2021; 12:734789. [PMID: 34650492 PMCID: PMC8505674 DOI: 10.3389/fpsyg.2021.734789] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/27/2021] [Indexed: 01/07/2023] Open
Abstract
Background: Rationing of nursing care is a serious issue that has been widely discussed throughout recent years in many countries. The level of satisfaction with life and of satisfaction with job as the nurse-related factors may significantly affect the level of care rationing. Aim: To assess the rationing of nursing care among the Polish nurses and the impact of nurse-related variables, i.e., satisfaction with life and satisfaction with job on the level of nursing care rationing. Materials and Methods: A cross-sectional study was conducted among 529 Polish registered nurses employing in two University Hospitals. Three self-report scales in the Polish version were used in this study, namely, Basel Extent of Rationing of Nursing Care-revised version (BERNCA-R), Satisfaction with Life Scale (SWLS), and Satisfaction with Work Scale (SWWS). Results: The respondents indicated that the most frequently rationed activity is studying the situation of individual patients and care plans at the beginning of the shift. The least frequently rationed activity indicated by the respondents was adequate hand hygiene. The patient-to-nurse ratio and the level of satisfaction with job are significant independent factors affecting the level of care rationing. Conclusions: The assessment of the level of satisfaction with life and identification of factors affecting this assessment will enable reducing the occurrence of care rationing.
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Affiliation(s)
- Aleksandra Kołtuniuk
- Department of Nervous System Diseases, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Izabela Witczak
- Department of Health Care Economics and Quality, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Karolina Czajor
- Department of Ophthalmology, Wroclaw Medical University, Wroclaw, Poland
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
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22
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Gurková E, Mikšová Z, Šáteková L. Missed nursing care in hospital environments during the COVID-19 pandemic. Int Nurs Rev 2021; 69:175-184. [PMID: 34433226 PMCID: PMC8653289 DOI: 10.1111/inr.12710] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 08/02/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Studies performed in Central European countries showed a high prevalence of missed nursing care in various clinical settings before the COVID-19 pandemic. AIMS The aim of the study was to investigate which domains of the work environment were significant predictors of missed nursing care activities in Czech hospitals during the COVID-19 pandemic. METHODS A cross-sectional study was used. The RANCARE guideline and STROBE checklist were followed for reporting in the study. The sample consisted of 371 nurses from four acute care hospitals. The MISSCARE Survey and the Practice Environment Scale of the Nursing Work Index questionnaires were used to collect data. The data were analyzed using multiple linear and logistic regression analyses. RESULTS Nurses reporting unfavorable environments consistently describe a higher frequency of episodes of missed care. Prevalence estimates of missed care in Czech acute care hospitals during the COVID-19 pandemic was predicted from the overtime work, the nurses' perception of the "Nursing foundations for the quality of care," and their satisfaction with their current position. CONCLUSIONS Missed nursing care could be mitigated by improving the nurses' work environment. Domains of the nurse work environment are known as structural modifiable factors and their refinement could be a cornerstone for interventions to reduce the prevalence of missed nursing care. IMPLICATIONS FOR NURSING POLICY Monitoring the conditions and aspects of the nurse work environment in hospitals and considering nurses' concerns about the work environment on an ongoing basis are important strategies for nurse supervision as well as for policymakers.
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Affiliation(s)
- Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Zdeňka Mikšová
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Lenka Šáteková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
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Jarošová D, Gurková E, Zeleníková R, Plevová I, Janíková E. Hospital and unit variables of missed nursing care in acute care hospitals: A cross-sectional study. J Clin Nurs 2021; 30:1099-1110. [PMID: 33434291 DOI: 10.1111/jocn.15655] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 11/23/2020] [Accepted: 12/31/2020] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To investigate hospital, unit and staff variables as the correlates of missed nursing care (MNC) in Czech hospitals. BACKGROUND There is a considerable variability in patterns of MNC across different hospital, unit and staff characteristics. DESIGN A cross-sectional study was conducted. The STROBE guidelines for reporting observational studies were followed for reporting of the research study. METHODS A sample of 513 nurses working in nine acute care hospitals was recruited. MNC activities were measured with the MISSCARE Survey. Data were analysed using descriptive statistics and univariate logistic regression. RESULTS Type of unit was confirmed as a significant predictor of MNC. Staff characteristics (nurses' work position, level of education and perceived adequacy of unit staff) and hospital variables did not contribute significantly to MNC. CONCLUSIONS The study replicated the patterns of MNC across different conceptual approaches. MNC was influenced by work environment characteristics rather than individual staff variables. RELEVANCE TO CLINICAL PRACTICE The results of this research showed that missed nursing care is influenced by work environment characteristics rather than individual staff variables.
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Affiliation(s)
- Darja Jarošová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacký University in Olomouc, Olomouc, Czech Republic
| | - Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Ilona Plevová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Eva Janíková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
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Bagnasco A, Catania G, Zanini M, Dasso N, Rossi S, Aleo G, Timmins F, Sermeus W, Aiken LH, Sasso L. Are data on missed nursing care useful for nursing leaders? The RN4CAST@IT cross-sectional study. J Nurs Manag 2020; 28:2136-2145. [PMID: 32881131 DOI: 10.1111/jonm.13139] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 08/04/2020] [Accepted: 08/20/2020] [Indexed: 11/30/2022]
Abstract
AIM To describe nurses' reported missed nursing care activities among hospitalized adult patients medical and surgical wards and explore gaps in service provision. BACKGROUND In 2015, Italy replicated the RN4CAST study, which heralded the exposition of missed care as an international phenomenon. In Italy, nurse-patient workload is high, with high levels of burnout and dissatisfaction reported, all factors associated with missed care. METHODS A cross-sectional study (n = 3,590) was conducted using the 13-item online Task Left Undone Tool aimed at collecting data on missed nursing care. RESULTS The frequency of omission of activities ranged between 7% and 50%. There were significant differences between morning, afternoon and night shifts and the various clinical settings. Oral care was the most frequently missed care activity. CONCLUSIONS This study takes step forward in identifying and reducing missed care on medical and surgical wards, both in Italy and also internationally, which needs to take into account the specific organisational characteristics of each setting. IMPLICATIONS FOR NURSING MANAGEMENT Although more essential activities are missed less frequently, much is known about the relational deficits such as information giving, education, communication and discharge advice, which managers ought to spearhead through local initiatives to improve these practices.
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Affiliation(s)
- Annamaria Bagnasco
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Gianluca Catania
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Milko Zanini
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Nicoletta Dasso
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Silvia Rossi
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Giuseppe Aleo
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | - Walter Sermeus
- Department of Public Health & Primary Care, KU Leuven, Leuven, Belgium
| | - Linda H Aiken
- Center for Health Outcomes and Policy Research, School of Nursing, University of Pennsylvania, Philadelphia, PA, USA
| | - Loredana Sasso
- Dipartimento di Scienze della Salute, Università degli Studi di Genova, Genoa, Italy
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Bagnasco A, Zanini M, Dasso N, Rossi S, Timmins F, Galanti MC, Aleo G, Catania G, Sasso L. Dignity, privacy, respect and choice-A scoping review of measurement of these concepts within acute healthcare practice. J Clin Nurs 2020; 29:1832-1857. [PMID: 32220088 DOI: 10.1111/jocn.15245] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 01/23/2020] [Accepted: 03/12/2020] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To synthesise and review literature related to instruments that measure psychosocial aspects of fundamental care in acute hospital care settings. BACKGROUND Psychosocial aspects of care often receive less priority in terms of care provision in acute care environments. At the same time, if these elements are overlooked, there may be consequences. Despite the availability of many instruments designed to measure specific aspects of care, these concepts are often not studied within the broader context of fundamentals of care, but rather coexist as isolated explorations of specific subelements. DESIGN A scoping review was conducted, based on Arksey & O'Malley's (2005) methodological framework and following the PRISMA checklist. METHODS Using the five recommended steps-identifying the research question; identifying relevant studies; study selection; charting the data; and summarising and reporting the results-three databases were searched: MEDLINE/PubMed, CINAHL and EMBASE, in February 2019. RESULTS Following independent screening by two of the authors, 48 papers were included. From these 48 papers, 33 instruments were identified. Only five of these tools thoroughly assessed psychosocial aspects elements of care (dignity, respect, privacy and patients' choice) through dedicated items. CONCLUSIONS This review provides nurses with a synthesis of 33 instruments that assess the psychosocial aspects of care. This provides an important resource to guide measurement of dignity, respect, privacy and patients' choice. The findings also provide guidance to future research in this field. RELEVANCE TO CLINICAL PRACTICE This paper reviews and synthesises these instruments to provide a resource to nurses to inform their decisions and practice around measurement and evaluation of these key aspects of care. This provides a useful guide to measure and monitor the improvement of fundamental care delivery in practice and points to strengths and weaknesses of the instruments concerned.
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Affiliation(s)
| | - Milko Zanini
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Nicoletta Dasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Silvia Rossi
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Fiona Timmins
- School of Nursing and Midwifery, Trinity College Dublin, Dublin, Ireland
| | | | - Giuseppe Aleo
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Gianluca Catania
- Department of Health Sciences, University of Genoa, Genoa, Italy
| | - Loredana Sasso
- Department of Health Sciences, University of Genoa, Genoa, Italy
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Uchmanowicz I, Kołtuniuk A, Młynarska A, Łagoda K, Witczak I, Rosińczuk J, Jones T. Polish adaptation and validation of the Perceived Implicit Rationing of Nursing Care (PIRNCA) questionnaire: a cross-sectional validation study. BMJ Open 2020; 10:e031994. [PMID: 32265239 PMCID: PMC7245423 DOI: 10.1136/bmjopen-2019-031994] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To develop a Polish adaptation of the Perceived Implicit Rationing of Nursing Care (PIRNCA)questionnaire. DESIGN Cross-sectional validation study. SETTINGS Nurses working in surgical and cancer wards in Poland. PARTICIPANTS A sample of 513 professionally active nurses was enrolled in the study. INTERVENTION To complete a Polish translation of the full original PIRNCA questionnaire. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was translation and adaptation of the full original PIRNCA tool and its validation to the Polish conditions. The secondary outcome was determination of relationships between sociodemographic variables, nurses' assessment of patient care quality and their overall job satisfaction on the one hand, and PIRNCA scores on the other. RESULTS The respondents' mean score was 1.27 points (SD=0.68) on a scale from 0 to 3. Cronbach's alpha for the entire instrument was 0.957. All items of the questionnaire were found to have a positive item-total correlation. The developed linear regression model showed that nurses' assessment of patient care quality and their overall job satisfaction were independent predictors of PIRNCA scores (p<0.05). 94.15% of nurses reported rationing at least one of the 31 care activities. CONCLUSIONS The present findings indicate a high level of reliability and validity of the translated PIRNCA questionnaire, fully comparable to that of the original. The questionnaire can be used for the assessment of PIRNCA in Polish hospitals.
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Affiliation(s)
| | - Aleksandra Kołtuniuk
- Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Agnieszka Młynarska
- Department of Gerontology and Geriatric Nursing, Medical University of Silesia, Katowice, Poland
| | - Katarzyna Łagoda
- Department of Clinical Medicine, Medical University of Bialystok, Bialystok, Poland
| | - Izabela Witczak
- Department of Economics and Quality in Health Care, Wroclaw Medical University, Wroclaw, Poland
| | - Joanna Rosińczuk
- Department of Nervous System Diseases, Wroclaw Medical University, Wroclaw, Poland
| | - Terry Jones
- Department of Adult Health and Nursing Systems, Virginia Commonwealth University School of Nursing, Richmond, Virginia, USA
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Zeleníková R, Gurková E, Friganovic A, Uchmanowicz I, Jarošová D, Žiaková K, Plevová I, Papastavrou E. Unfinished nursing care in four central European countries. J Nurs Manag 2019; 28:1888-1900. [PMID: 31680373 PMCID: PMC7754486 DOI: 10.1111/jonm.12896] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 10/27/2019] [Accepted: 10/31/2019] [Indexed: 12/02/2022]
Abstract
Aim The main aim of the research was to describe and compare unfinished nursing care in selected European countries. Background The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities. Methods A cross‐sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia). Results The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care. Conclusion The research results confirmed the prevalence of unfinished nursing care in the countries surveyed. Implications for Nursing Management The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care.
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Affiliation(s)
- Renáta Zeleníková
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Elena Gurková
- Department of Nursing, Faculty of Health Sciences, Palacky University in Olomouc, Olomouc, Czech Republic
| | - Adriano Friganovic
- University Hospital Zagreb, Zagreb, Croatia.,University of Applied Health Sciences, Zagreb, Croatia
| | - Izabella Uchmanowicz
- Department of Clinical Nursing, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Darja Jarošová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Katarína Žiaková
- Department of Nursing, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovakia
| | - Ilona Plevová
- Department of Nursing and Midwifery, Faculty of Medicine, University of Ostrava, Ostrava, Czech Republic
| | - Evridiki Papastavrou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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