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.
There is no agreed minimum standard with regard to what is considered safe, competent nursing care. Limited resources and organizational constraints make it challenging to develop a minimum standard. ...As part of their everyday practice, nurses have to ration nursing care and prioritize what care to postpone, leave out, and/or omit. In developed countries where public healthcare is tax-funded, a minimum level of healthcare is a patient right; however, what this entails in a given patient’s actual situation is unclear. Thus, both patients and nurses would benefit from the development of a minimum standard of nursing care. Clarity on this matter is also of ethical and legal concern. In this article, we explore the case for developing a minimum standard to ensure safe and competent nursing care services. Any such standard must encompass knowledge of basic principles of clinical nursing and preservation of moral values, as well as managerial issues, such as manpower planning, skill-mix, and time to care. In order for such standards to aid in providing safe and competent nursing care, they should be in compliance with accepted evidence-based nursing knowledge, based on patients’ needs and legal rights to healthcare and on nurses’ codes of ethics. That is, a minimum standard must uphold a satisfactory level of quality in terms of both professionalism and ethics. Rather than being fixed, the minimum standard should be adjusted according to patients’ needs in different settings and may thus be different in different contexts and countries.
Aims and objectives
To investigate how fundamental aspects of nursing care have been defined in the literature from 2010–2016.
Background
A 2010 narrative review of nursing texts identified little ...consensus on what constitutes the fundamental aspects of nursing care. Since then there has been a proliferation of policies, strategic frameworks and research teams dedicated to investigating such care. It is unclear whether this increased activity has led to greater conceptual clarity.
Design
Scoping review using the Joanna Briggs Institute methodology.
Methods
A search of published and grey literature was undertaken using CINAHL, Scopus, PubMed and ProQuest. Documents providing a definition for fundamental aspects of nursing care were included for review. Definitions were identified and mapped.
Results
Forty‐nine documents were included. Two ways of constructing the discourse around fundamental aspects of nursing care were identified: compassionate care (n = 25) and fundamentals of care (n = 24). The literature on compassionate care focused primarily on the moral attributes of nurses and their ability to establish meaningful connections with patients. The literature on fundamentals of care was split between describing such care as a list of nursing activities and describing it as a complex, multidimensional construct.
Conclusions
There appears to be a lack of consensus around how fundamental aspects of nursing care are defined. Compassionate care and fundamentals of care have commonalities in terms of emphasising the nurse–patient relationship; however, only the literature on fundamentals of care addresses patients’ physical care needs. Despite their commonalities, it seems the two bodies of work are being developed largely independent of one another.
Relevance to clinical practice
This scoping review identified areas of convergence and divergence around fundamental aspects of nursing care. An agreed definition for such care is needed to enable the development of a robust evidence base to underpin the coherent and consistent development of nursing practice.
In dieser werden die Empfehlungen zusammengefasst und mit markanten Überschriften oder Slogans sowie humorvollen Bildern kombiniert. Beteiligt waren daran 25 Pflegeexpertinnen und -experten bzw. ...erfahrene Pflegerpersonen, das Department für Evidenzbasierte Medizin und Evaluation mit Cochrane Österreich an der Universität für Weiterbildung Krems, sowie das Institut für Allgemeinmedizin und evidenzbasierte Versorgungsforschung (IAMEV) der Medizinischen Universität Graz. The association between nurse staffing and omissions in nursing care: A systematic review.
Introduction: The sizable population of people with respiratory conditions places a significant demand on healthcare services and a need for specialized nursing care.
Aim: The ERS Nursing Group ...recognized the need for harmonized curricula for respiratory nurses. The following steps incorporate the knowledge and experience of academic and clinical experts.
Methodology: Steps in the Delphi Process for ICRN (Cantrill, et al. Int. J Pharm. Prac, 1996):
1) 2020 - Choose Facilitator; ERS chair & 2 researchers (Sajnic A, Narsavage G, Kelly C),
2) 2020 - Identify Experts; ICRN Advisory Group, in 2021, a group was added to support patient involvement,
3) 2021 - Define the Problem; ICRN Global Needs Survey (Narsavage et al.) confirmed the need for ICRN and assessed the status of respiratory nursing in 25 countries worldwide,
4) Review the literature; scoping review in process (2022) for a starting point for survey questions,
5) Round One Questions; country-based focus groups and literature summarized by the advisory group will form survey for global group. Common items will constitute a Round Two survey,
6) Round Two Questions; a survey will identify ICRN items and summarize common areas,
7) Round Three Questions; what the experts are all agreed upon will be answered,
8) Act on Findings; a consensus document for the core curriculum will be published.
Conclusion: Worldwide recognition of respiratory nursing as a speciality with a harmonized ICRN based on the Delphi process can be effective in improving the quality of care and patients' outcomes in active partnerships with other healthcare professionals
Aim
To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient‐to‐nurse ratio, job satisfaction, burnout, intention to leave and ...quality nursing care.
Background
Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient‐to‐nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model.
Design
A cross‐sectional survey.
Methods
The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model.
Results
The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient‐to‐nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout.
Conclusions
This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses’ work conditions of work environment and patient‐to‐nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care.
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