Rationing of Nursing Care and Patient Safety

Witczak, Izabela; Rypicz, Łukasz; Karniej, Piotr; Młynarska, Agnieszka; Kubielas, Grzegorz; Uchmanowicz, Izabella

doi:10.3389/fpsyg.2021.676970

Cited by 25 publications

(23 citation statements)

References 40 publications

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“…Organizational factors, including those related to financial savings and leadership, have the consequences of a lack, or rationing, of nursing care. Research by Witczak et al provided evidence that an increased risk of rationing care is associated with a deteriorated working environment for nurses [ 47 ]. This has been confirmed in our own research.…”

Section: Discussionmentioning

confidence: 99%

Factors Influencing the Rationing of Nursing Care in Selected Polish Hospitals

et al. 2022

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Introduction: The rationalization of nursing care can be a direct consequence of the low employment rate or unfavorable working environment of nurses. Aim: The aim of the study was to learn about the factors influencing the rationing of nursing care. Methods: The study group consisted of 209 nurses working in internal medicine departments. The study used the method of a diagnostic survey, a survey technique with the use of research tools: the BERNCA-R questionnaire and the PES-NWI questionnaire (which includes the occupational burnout questionnaire). Results: The mean total BERNCA score for rationing nursing care was 1.94 ± 0.75 on a scale from 0 to 4. A statistically significant relationship was demonstrated between the work environment and the rationing of nursing care. The results of the BERNCA-R scale correlated statistically significantly and positively (r ˃ 0) with two (out of three) subscales of the occupational burnout questionnaire (MBI—Maslach Burnout Inventory): emotional exhaustion and depersonalization (p < 0.001), and with all types of adverse events analyzed (p < 0.05). Conclusions: The higher the frequency of care rationing, the worse the assessment of working conditions by nurses, and, therefore, more frequent care rationing determined the more frequent occurrence of adverse events. The more frequent the care rationing, the more frequent adverse events occur.

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Section: Discussionmentioning

confidence: 99%

Factors Influencing the Rationing of Nursing Care in Selected Polish Hospitals

et al. 2022

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“…RNC has been recognized based on the observations of the work of U.S. nurses, but it applies to all countries worldwide, regardless of the health care system’s organization or funding [ 3 ]. Most evidence of RNC comes from nursing questionnaires or the opinions of the patients.…”

Section: Introductionmentioning

confidence: 99%

Determinants Affecting the Rationing of Nursing Care and Professional Burnout among Oncology Nurses

Piotrowska

Lisowska

Twardak

et al. 2022

IJERPH

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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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“…Better performance of nursing processes and care practices, in addition to patients’ health, also affects the health of nurses. [ 12 ] Nurses should be educated about care strategies, and they know the principles of care scientifically. [ 13 ] The present study is based on the findings of nurses’ reports in hospitals of Iran.…”

Section: Discussionmentioning

confidence: 99%

Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing

Khosravi¹,

Dehkourdi

Dezfouli

et al. 2022

J Family Med Prim Care

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Background: Clinical care and nursing skills are important issues that can influence the efficacy of treatment, the health of patients, and medical errors. The aim of this study was to investigate the readiness of medical staff in the field of effectiveness and evaluation of clinical care and nursing skills. Materials and methods: This descriptive, cross-sectional study was performed on 99 medical staff working in hospitals from August 2020 to December 2021. The instrument used was a checklist for the effectiveness and evaluation of clinical care based on the findings of the nursing reports. Data were analyzed by statistical software. Results: The mean age of nurses was 37.5 years. Among the participants, 16.3% were male and 85.7% were female; 56.6% of nurses had completed clinical care. The overall performance of nurses in drug-related care and nursing processes was observed to be acceptable. Nurses were successful in performing many aspects of the nursing processes of repulsion, absorption, and dressing and showed good preparation. In relation to gavage, a high percentage of nurses performed the procedure well. However, in some cases, such as medication-related care, handwashing, and the use of personal protective equipment, where there is a possibility of touching the blood or other body fluids of the patients, the performance of nurses was moderate. Conclusion: The findings of this research demonstrated that there are limitations, strengths, and weaknesses in terms of some aspects such as medication, care and nursing processes, compliance with standards, and infection control, which can be considered to improve the performance of nurses in the future.

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Rationing of Nursing Care and Patient Safety

Cited by 25 publications

References 40 publications

Factors Influencing the Rationing of Nursing Care in Selected Polish Hospitals

Factors Influencing the Rationing of Nursing Care in Selected Polish Hospitals

Determinants Affecting the Rationing of Nursing Care and Professional Burnout among Oncology Nurses

Study of readiness and performance of nurses in evaluating clinical care and processes of care and nursing

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