Abstract
Rationed nursing care is a significant problem in healthcare facilities worldwide. Awareness of contributing factors to rationed care might support the development and implementation of strategies for reducing this phenomenon from clinical practice. The study examined the association between selected hospital, unit, and staff variables and the prevalence of rationed nursing care. Secondary analysis of cross-sectional data collected between December 2017 and July 2018 from 895 registered nurses in seven acute care hospitals in the Slovak Republic was performed. Data were collected using the questionnaire Perceived Implicit Rationing of Nursing and analyzed by descriptive and inferential statistics in the statistical program SPSS 25.0. Statistically significant associations were found between rationed nursing care and unit type, education, shift type, nurses’ experience in the current unit, overtime hours, missed shifts, intention to leave the position, perceived staff adequacy, quality of patient care, and job satisfaction. Differences in rating rationed nursing care, quality of patient care, and job satisfaction were identified based on hospital type. Together with top hospital management, nurse managers should develop targeted interventions focusing on mitigating rationed nursing care from the clinical practice with a focus placed on university hospitals. Quality and safe care might be ensured through constant monitoring of the quality of patient care and job satisfaction of nurses as these factors significantly predicted the estimates of rationed nursing care.
Highlights
Rationed nursing care represents a significant topic within the nursing researchers’community
The mean composite score for the entire Perceived Implicit Rationing of Nursing Care (PIRNCA) instrument was 1.74 (SD = 0.91), which indicated that care tended to be rarely rationed rather than sometimes
Hospital management should regularly assess factors contributing to rationed nursing care and address them to eliminate them from the clinical practice
Summary
Rationed nursing care represents a significant topic within the nursing researchers’. In the past twenty years, the number of publications related to the phenomenon of rationed nursing care has increased. In literature, rationed nursing care is defined as withholding necessary nursing care activities by nurses during their working shifts. The phenomenon occurs in the healthcare system when available resources are insufficient to deliver adequate nursing care to patients. These resources refer mainly to labor or material resources, communication, teamwork, or time [1].
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