Background
Rationing of care in nursing is nurses' inability to complete all care activities for patients because of scarcity in time and resource. Literature suggests that rationing of care is ...closely related to patient safety and quality of care. The phenomena have been defined and studied from varied perspectives and contexts. A systematic review of studies related to the concept was aimed at identifying and synthesizing the finding.
Methods
The review followed Preferred Reporting Items for Systematic Reviews and Meta‐analysis guidelines, and literature searches were conducted in MEDLINE, CINAHL, PsycInfo, Web of Science and EMBASE databases. Fifty‐seven quantitative studies were included in the review.
Findings
The review observed that nursing activities addressing the emotional, educational, mobility and hygiene needs of the patients were commonly rationed. Antecedents of rationing included resource inadequacy and organizational work environment. Rationing influenced patient satisfaction, mortality and a number of adverse events and was associated with decreased job satisfaction, increased intention to leave and high turnover among nurses.
Discussions
This review concludes that rationing in nursing is ubiquitous, embedded in the work environment and poses a threat to the professional health and philosophical base of nursing in addition to having serious implications on patients' safety. Strategies to reframe and reconsider organizational traits, and open discussion with other healthcare stakeholders can reduce rationing of nursing care. The review suggests future researchers adopt different methodological layout to study rationing.
Background
Missed nursing care is a global phenomenon affecting patient safety and quality of care. The working environment of nurses seems to play an important role in missed nursing care.
Aims
This ...study was conceptualized to explore the link of environmental constraints with missed nursing care in the Indian context.
Method
A convergent mixed‐method design was adopted, and data was collected using Kalisch's MISSCARE survey from 205 randomly selected nurses involved in direct patient care in the acute care settings of four tertiary care hospitals in India. In the qualitative phase, in‐depth interviews regarding nurses' experience of missed care were performed with 12 nurses chosen by maximum variant sampling from the quantitative sample.
Results
The integrated results revealed that nurses experience a sense of competing priority in the environment where curative and prescribed tasks like medication administration get more priority than activities like communication, discharge teaching, oral hygiene, and emotional support, which are frequently missed. The human resource and communication constraints together explained 40.6% of variance in missed nursing care. Human resource inadequacy in times of increased workload was the most frequently cited reason for missed care. Converging with this finding, nurses in the interviews expressed that maintaining a flexible number of staff and catering to the variable workload can effectively reduce missed nursing care. Frequent interruption of nursing activities by medical staff and lack of structure in some activities were cited as important reasons for missed care.
Linking Evidence to Action
Nursing leaders need to acknowledge missed care in nursing and develop policies to maintain flexible staffing based on situational workload. Methods of staffing like NHPPD (Nursing hour per patient day) which are more sensitive to nursing workload, and patient turnover, can be adopted instead of a fixed nurse–patient mandate. Mutual support from team members and multi‐professional cooperation can reduce frequent interruption of nursing tasks thereby reducing missed care.
Abstract
Purpose:
To identify and synthesize the findings of studies related to “rationing of nursing care”.
Methods:
Preferred Reporting Items for Systematic Reviews and Meta analysis (PRISMA) ...guidelines will be followed in this review and literature searches will be conducted in MEDLINE, CINAHL, Psyc Info, Web of Science and EMBASE databases. Only quantitative studies meeting the predetermined inclusion criteria, quality standards and credibility will be synthesised using narrative synthesis.
Results:
A descriptive synthesis of the findings of the selected studies will be carried out which will be presented in narrative summary with statistical findings incorporated.
Conclusion:
This review will provide a synthesis of up to date evidence regarding the rationing of care by nurses. It will also support the hypothesis that rationing of care has effects on patients and nurses and explore relationship of rationing of care with patients and nursing outcome.
Purpose : To identify and synthesize the findings of studies related to "rationing of nursing care".Methods : Preferred Reporting Items for Systematic Reviews and Meta analysis (PRISMA) guidelines ...will be followed in this review and literature searches will be conducted in MEDLINE, CINAHL, Psyc Info, Web of Science and EMBASE databases. Only quantitative studies meeting the predetermined inclusion criteria, quality standards and credibility will be synthesised using narrative synthesis.Results : A descriptive synthesis of the findings of the selected studies will be carried out which will be presented in narrative summary with statistical findings incorporated.Conclusion : This review will provide a synthesis of up to date evidence regarding the rationing of care by nurses. It will also support the hypothesis that rationing of care has effects on patients and nurses and explore relationship of rationing of care with patients and nursing outcome.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
A
bstract
In this paper, we obtain a bulk dual to the low energy sector of the SYK model, including SYK model with U(1) charge, by Kaluza-Klein (KK) reduction from three dimensions. We show that KK ...reduction of the 3D Einstein action plus its boundary term gives the Jackiw-Teitelboim (JT) model in 2D with the appropriate 1D boundary term. The size of the KK radius gets identified with the value of the dilaton in the resulting near-AdS2 geometry. In presence of U(1) charge, the 3D model additionally includes a U(1) Chern-Simons (CS) action. In order to describe a boundary theory with non-zero chemical potential, we also introduce a coupling between CS gauge field and bulk gravity. The 3D CS action plus the new coupling term with appropriate boundary terms reduce in two dimensions to a BF-type action plus a source term and boundary terms. The KK reduced 2D theory represents the soft sector of the charged SYK model. The pseudo-Nambu-Goldstone modes of combined
Diff
/SL(2
,
ℝ) and U(1)
local
/
U(1) transformations are represented by combined large diffeomorphisms and large gauge transformations. The effective action of the former is reproduced by the action cost of the latter in the bulk dual, after appropriate identification of parameters. We compute chaotic correlators from the bulk and reproduce the result that the contribution from the “boundary photons” corresponds to zero Liapunov exponent.
The electrode polarization impedance type flow transducer is a simple, obstruction less, and cost-effective flow meter for measuring the flow rate of the conductive liquid. In this flow meter, four ...electrodes placed diametrically opposite to each other with a separation of certain distance forms a bridge. The flow transducer output nonlinearly varies with flow rate, excitation frequency, current density, and separation distance between the electrodes. In this paper, we have observed and analyzed the effect of output of electrode polarization type flow meter with the variation in separation distance between the electrodes. In this paper, after theoretical analysis, the experiment has been performed, and its results and graphs are reported. It has been observed that the experimental results follow the theoretically derived equations.
The electrode polarization-based flow meter is a simple and cost-effective flow meter, which utilizes the effect of flow of fluid on the polarization impedance that exists between the two electrodes ...for the measurement of flow rate of conductive fluid. It consists of two pairs of electrodes which are placed diametrically opposite to each other. Among these four electrodes, two diagonally placed electrodes are driven electrodes and other two diagonally placed electrodes serve as an output pickup. The output of polarization impedance-based flow metergets influence of excitation frequency, current density, ions constituents, conductivity of electrolyte solution, and temperature and area of electrodes. In this paper, we have analyzed and investigated the influence of electrodes area on the characteristics of electrode polarization-based flow meter. The experiment has been performed after the theoretical investigation and its results are reported in this paper. The performance of the flow meter is investigated by finite element method (FEM) usingComsol 5.4 Multiphysics simulation software. The simulation result shows that the variation in output of flow sensor with respect to the variation of diameter. The experiment results match quite well with simulations. It has been also observed that the result derived from the experiment exactly follows the theoretically derived equations.
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•Tannery industry waste sludge was previously reported for heavy metal removal.•Generated metal-loaded spent biosorbent was reused for herbicide removal.•Elucidation of mechanism by ...FTIR, XPS, XRD, XRF, FESEM-EDX elemental-mapping.•Phosphonate group of glyphosate forms complex with surface bound multi-metals.•Herbicide loaded biosorbent were inertized into glass for safe disposal.
Extensive uses of glyphosate herbicide pose the environmental concerns of surface and ground water contaminations through leaching. The present investigation is based on potential reuse of multi-metal laden spent biosorbent for glyphosate removal. Our previous study showed effective removal of Ni(II), Co(II), Zn(II) and Cd(II) ions in multi-metal system using waste activated sludge from tannery industry as biosorbent. Glyphosate biosorption efficiency of the waste tannery sludge was enhanced from 26.18% to >92% after increase in the multi-metal loading on the sludge. Feasibility study for actual wastewater treatment showed about 91.7% removal of glyphosate in the simulated agricultural runoff. The glyphosate biosorption exhibited gradual removal process. The rapid 70–75% biosorption was attained in first 2 h of contact time and the final removal of 89–94% was achieved within 24–28 h of contact time. Equilibrium isotherm and kinetics data were obtained by adsorption experiments. Biosorbent characterization and removal mechanism were established. The formation of glyphosate-metal complexation was confirmed by the FTIR, XPS, XRD, XRF, FESEM-EDAX and elemental mapping results. Surface bound multi-metals of the biosorbent could predominantly form mononuclear, bi-, tri- or tetra-dentate complexes through phosphonate group of glyphosate molecule. Weak binding of glyphosate molecule with the carboxyl and amino groups also occurred. The glyphosate loaded biosorbent were successfully inertized up to 10 wt% in phosphate glass matrix as confirmed by XRD for safe disposal of the toxic sludge in the environment.
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