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Rationing of Nursing Care: An International and Multidimensional Problem

  • António Casa NovaEmail author
  • Raul Cordeiro
  • Olga Riklikiene
Chapter
Part of the Lecture Notes in Logistics book series (LNLO)

Abstract

Rationing of nursing care occurs when resources are insufficient to provide necessary care to all patients. This may be a result of reduced staff numbers, skill mix variation, increased demands for care or a changing patient profile. It is a result of a policy decision making by nurse managers who are faced with reduced resources while striving to provide care, rather than by policy makers, and often involves choices, which impact on care delivery and patient safety. Under the auspices of Working Group #4 in COST Action 15208—Rationing Nursing Care: an international and multidimensional problem, is developing a consensus work on the construction of a Guide for Nursing Managers called Promoting patient safety through minimizing missed nursing care. This work has been conducted in several stages. It was started with the development of a proposal and at this time has been discussed in several scientific nursing events throughout Europe. The task will be complete for publication by the end of 2020.

Keywords

Health care rationing Nursing care Cost containment Quality 

Notes

Acknowledgements

The authors thank the members of the COST Action 15208 (Rationing—Missed Nursing care: An international and multidimensional problem) for the availability in verifying the information produced in this article.

References

  1. Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J. A., Busse, R., Clarke, H., et al. (2001). Nurses’ reports on hospital care in five countries. Health affairs (Millwood), 20(3), 43–53.  https://doi.org/10.1377/hlthaff.20.3.43.CrossRefGoogle Scholar
  2. Aiken, L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R., McKee, M., et al. (2012). Patient safety, satisfaction, and quality of hospital care: Cross sectional surveys of nurses and patients in 12 countries in Europe and the United States. BMJ, 344, e1717.CrossRefGoogle Scholar
  3. Ausserhofer, D., Schubert, M., Desmedt, M., Blegen, M. A., De Geest, S., & Schwendimann, R. (2013). The association of patient safety climate and nurse-related organizational factors with selected patient outcomes: A cross-sectional survey. International Journal of Nursing Studies, 50(2), 240–252.  https://doi.org/10.1016/j.ijnurstu.2012.04.007.CrossRefPubMedGoogle Scholar
  4. Ausserhofer, D., Zander, B., Busse, R., Schubert, M., De Geest, S., Rafferty, A. M., et al. (2014). Prevalence, patterns and predictors of nursing care left undone in European hospitals: Results from the multicountry cross-sectional RN4CAST study. BMJ Quality & Safety, 23(2), 126–135.CrossRefGoogle Scholar
  5. Ball, J. E., Bruyneel, L., Aiken, L. H., Sermeus, W., Sloane, D. M., Rafferty, A. M., et al. (2018). Post-operative mortality, missed care and nurse staffing in nine countries: A cross-sectional study. International Journal of Nursing Studies, 78, 10–15.  https://doi.org/10.1016/j.ijnurstu.2017.08.004.
  6. Ball, J. E., Griffiths, P., Rafferty, A. M., Lindqvist, R., Murrells, T., & Tishelman, C. (2016). A cross-sectional study of ‘care left undone’ on nursing shifts in hospitals. Journal of Advanced Nursing, 72(9), 2086–2097.  https://doi.org/10.1111/jan.12976.CrossRefPubMedGoogle Scholar
  7. Ball, J. E., Murrells, T., Rafferty, A. M., Morrow, E., & Griffiths, P. (2014). ‘Care left undone’ during nursing shifts: Associations with workload and perceived quality of care. BMJ Quality and Safety, 23(2), 116–125.  https://doi.org/10.1136/bmjqs-2012-001767.CrossRefPubMedGoogle Scholar
  8. Bragadóttir, H., Kalisch, B. J., & Tryggvadóttir, G. B. (2017). Correlates and predictors of missed nursing care in hospitals. Journal of Clinical Nursing, 26(11–12), 1524–1534.  https://doi.org/10.1111/jocn.13449. Epub 20 Mar 2017.CrossRefPubMedGoogle Scholar
  9. Bruyneel, L., Li, B., Ausserhofer, D., Lesaffre, E., Dumitrescu, I., Smith, H. L., et al. (2015). Organization of hospital nursing, provision of nursing care, and patient experiences with care in Europe. Medical Care Research and Review, 72(6), 643–664.  https://doi.org/10.1177/1077558715589188.CrossRefPubMedGoogle Scholar
  10. Jones, T. L. (2014). Validation of the perceived implicit rationing of nursing care (PIRNCA) instrument. Nursing Forum, 49(2), 77–87.  https://doi.org/10.1111/nuf.12076.CrossRefPubMedGoogle Scholar
  11. Jones, T. L., Hamilton, P., & Murry, N. (2015). Unfinished nursing care, missed care, and implicitly rationed care: State of the science review. International Journal of Nursing Studies, 52(6), 1121–1137.  https://doi.org/10.1016/j.ijnurstu.2015.02.012.CrossRefPubMedGoogle Scholar
  12. Kalisch, B. J., Landstrom, G. L., & Hinshaw, A. S. (2009). Missed nursing care: A concept analysis. Journal of Advanced Nursing, 65(7), 1509–1517.  https://doi.org/10.1111/j.1365-2648.2009.05027.x.CrossRefPubMedGoogle Scholar
  13. Kalisch, B. J., Tschannen, D., Lee, H., & Friese, C. R. (2011). Hospital variation in missed nursing care. American Journal of Medical Quality, 26(4), 291–299.  https://doi.org/10.1177/1062860610395929.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Kalisch, B. J., Tschannen, D., & Lee, K. H. (2012). Missed nursing care, staffing, and patient falls. Journal of Nursing Care Quality, 27(1), 6–12.  https://doi.org/10.1097/NCQ.0b013e318225aa23.CrossRefPubMedGoogle Scholar
  15. Kalisch, B. J., & Williams, R. A. (2009). Development and psychometric testing of a tool to measure missed nursing care. Journal of Nursing Administration, 39(5), 211–219.  https://doi.org/10.1097/NNA.0b013e3181a23cf5.CrossRefPubMedGoogle Scholar
  16. Kane, R. L., Shamliyan, T. A., Mueller, C., Duval, S., & Wilt, T. J. (2007). The association of registered nurse staffing levels and patient outcomes: Systematic review and meta-analysis. Medical Care, 45(12), 1195–1204.  https://doi.org/10.1097/MLR.0b013e3181468ca3.CrossRefPubMedGoogle Scholar
  17. Kutney-Lee, A., McHugh, M. D., Sloane, D. M., Cimiotti, J. P., Flynn, L., Neff, D. F., et al. (2009). Nursing: A key to patient satisfaction. Health Affairs (Millwood), 28(4), w669–w677.  https://doi.org/10.1377/hlthaff.28.4.w669.CrossRefGoogle Scholar
  18. Lucero, R. J., Lake, E. T., & Aiken, L. H. (2010). Nursing care quality and adverse events in US hospitals. Journal of Clinical Nursing, 19(15–16), 2185–2195.  https://doi.org/10.1111/j.1365-2702.2010.03250.x.CrossRefPubMedPubMedCentralGoogle Scholar
  19. Papastavrou, E., Andreou, P., & Vryonides, S. (2014). The hidden ethical element of nursing care rationing. Nursing Ethics, 21(5), 583–593.  https://doi.org/10.1177/0969733013513210.CrossRefPubMedGoogle Scholar
  20. Schubert, M., Ausserhofer, D., Desmedt, M., Schwendimann, R., Lesaffre, E., Li, B., et al. (2013). Levels and correlates of implicit rationing of nursing care in Swiss acute care hospitals—A cross sectional study. International Journal of Nursing Studies, 50(2), 230–239.  https://doi.org/10.1016/j.ijnurstu.2012.09.016.CrossRefPubMedGoogle Scholar
  21. Schubert, M., Clarke, S. P., Aiken, L. H., & de Geest, S. (2012). Associations between rationing of nursing care and inpatient mortality in Swiss hospitals. International Journal for Quality in Health Care, 24(3), 230–238.  https://doi.org/10.1093/intqhc/mzs009.CrossRefPubMedGoogle Scholar
  22. Schubert, M., Clarke, S. P., Glass, T. R., Schaffert-Witvliet, B., & De Geest, S. (2009). Identifying thresholds for relationships between impacts of rationing of nursing care and nurse- and patient-reported outcomes in Swiss hospitals: A correlational study. International Journal of Nursing Studies, 46(7), 884–893.  https://doi.org/10.1016/j.ijnurstu.2008.10.008.CrossRefPubMedGoogle Scholar
  23. Schubert, M., Glass, T. R., Clarke, S. P., Aiken, L. H., Schaffert-Witvliet, B., Sloane, D. M., et al. (2008). Rationing of nursing care and its relationship to patient outcomes: The Swiss extension of the International Hospital Outcomes Study. International Journal for Quality in Health Care, 20(4), 227–237.  https://doi.org/10.1093/intqhc/mzn017.CrossRefPubMedPubMedCentralGoogle Scholar
  24. Schubert, M., Glass, T. R., Clarke, S. P., Schaffert-Witvliet, B., & De Geest, S. (2007). Validation of the basel extent of rationing of nursing care instrument. Nursing Research, 56(6), 416–424.  https://doi.org/10.1097/01.NNR.0000299853.52429.62.CrossRefPubMedGoogle Scholar
  25. Scott, P. A., Harvey, C., Felzmann, H., Suhonen, R., Habermann, M., Halvorsen, K., & Papastavrou, E. (2018). Resource allocation and rationing in nursing care: A discussion paper. Nursing Ethics. 969733018759831.  https://doi.org/10.1177/0969733018759831.
  26. Uchmanowicz, I. (2017). Missed nursing care-what went wrong. Central European Journal of Nursing and Midwifery, 8(2), 609.CrossRefGoogle Scholar
  27. Wong, C. A., Cummings, G. G., & Ducharme, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21(5), 709–724.  https://doi.org/10.1111/jonm.12116.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • António Casa Nova
    • 1
    Email author
  • Raul Cordeiro
    • 1
    • 2
    • 3
    • 4
  • Olga Riklikiene
    • 5
  1. 1.Polytechnic Institute of PortalegrePortalegrePortugal
  2. 2.UIESI – Nursing Research Unit for South and IslandsPortalegrePortugal
  3. 3.VALORIZA – Research Center for Endogenous Resource ValorizationPortalegrePortugal
  4. 4.CINTESIS, Polytechnic Institute of PortalegrePortalegrePortugal
  5. 5.Faculty of Nursing, Department of Nursing and CareLithuanian University of Health SciencesKaunasLithuania

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