Rationing of Nursing Care on Example of Selected Health Care Facility.

Katarzyna Tomaszewska,Bożena Majchrowicz,Dorota Ratusznik

doi:10.3390/ijerph182312824

Abstract

Contemporary health determinants require nurses to develop new competencies and skills while performing complex tasks in all forms of health care. The problem of rationing of care is present all over the world and usually occurs when available resources are too low to provide adequate care to all patients. The most common reasons for loss of care are shortages of nurses, use of modern treatment methods, increased demand for care by a large number of patients, and greater knowledge of patients about their rights. A questionnaire survey was conducted among 295 nurses employed in hospital wards. The survey was conducted from September to December 2020 using the standardized BERNCA (The Basel Extent of Rationing of Nursing Care) questionnaire to measure the level of rationing of nursing care. The research was hampered by the sanitation regime associated with the SARS CoV-2 pandemic. Nursing care rationing is dependent on seniority and place of work. The mean total BERNCA score of the degree of rationing of nursing care was 2.58 ± 0.96 on a scale of 0 to 4 (where 0 means “no need for it” and 4 means “often”. The median score was 2.69. The higher frequency of rationing nursing care was characteristic of those working on surgical wards. The mean score obtained by them was 2.72 ± 0.86, with the median equal to 2.88. In the case of nurses employed in non-surgical wards, the scores were 2.08 ± 1.07 and 2.28, respectively. Rationing of nursing care is dependent on seniority and work location, with a higher degree of rationing of care occurring in surgical units.

Highlights

Quality of medical care is the top priority in healthcare
The higher frequency of rationing nursing care was characteristic of those working on surgical wards
In the case of nurses working on non-surgical wards, the results were 2.08 ± 1.07 and 2.28, respectively (Table 2)

Summary

Introduction

A large role in determining the level of quality of care is played by the actions taken by the nursing staff, and rationing is said to occur when the resources available to provide care to patients are insufficient. This is most often the case when the remaining nurses are unable to carry out the patient care plan because there are not enough nurses on duty. The concept of loss or rationing of care occurs when required patient care is partially or completely missed, meaning that some elements of care delivery are delayed and some cannot be completed [1]. The most common reasons for loss of care in addition to too few nurses are

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