The Phenomenon of Rationing Nursing Care in Czech Hospitals – a Pilot Study
Authors:
Iva Marková 1; Darja Jarošová 1
Authors‘ workplace:
Ústav ošetřovatelství a porodní asistence, Lékařská fakulta, Ostravská univerzita
1
Published in:
Prakt. Lék. 2021; 101(Suplementum 1, díl 2.): 17-21
Category:
Overview
Introduction: At present, there is one specific phenomenon occurring in a nursing care environment that is perceived and monitored worldwide in a nursing care environment and it is incomplete, delayed or rationing nursing interventions. In the Czech Republic, the research on this phenomenon has still been at the very beginning. Rationing nursing care, which was defined by Schubert M. et al. (2007), as a failure of a nurse to perform nursing interventions for some reason, most often due to a lack of time or staff, becomes known to Czech nurses.
Aim: The aim of the pilot study was to determine the incidence of rationing nursing care in Czech hospitals and to evaluate the working environment of nurses.
Method: The pilot study was performed (June 2020), in which 47 nurses working in acute care hospitals in selected regions of the Czech Republic participated PIRNCA and PES-NWI tools were used for data collection.
Results: The most frequently rationing interventions were found: nurse delay longer than 5 minutes (80.85%), emotional support of the patient (78.73%), safe handling of the patient (65.97%). The least rationing interventions were: administration of enteral and parenteral nutrition (12.77%) and a communication with an external agency (12, 77%). The most common reasons for the rationing care: lack of staff, lack of material and deteriorating condition of patients. An unfavourable working environment was evaluated only in 10.64%, mostly in the area of the patient’s deteriorating condition and shortcomings in service delivery.
Conclusion: The pilot study confirms the occurrence of rationing nursing care and reveals the areas where rationing care occurs. The working environment was found to be mixed or favourable. The tools used are accepted by nurses and further research could provide evidence on the factors that influence the development of rationing nursing care.
Keywords:
rationing - unfinished - missing nursing care – work environment – PIRNCA – PES-NWI
Sources
- Ausserhofer, D., Zander, B., Busse, R., et al. (2014) RN4CAST consortium. 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. Dostupné z: https:// doi:10.1136/bmjqs-2013-002318
- Bachnik S., Ausserhofer D., Baernholdt M. et al. (2018) Patient-centred care, nurse work environment and implicit rationing of nursing care in Swiss acute hospitals: A cross-sectional multi-center study. International Journal of Nursing Studies, 81(1) 98-106. Dostupné z: https://doi. org/10.1016/j.ijnurstu.2017.11.0127
- Blackman I., Henderson J., Willis E. et al. (2014) Factors influecing why nursing care is missed. Journal of Clinical Nursing, 24(1), 47-56. Dostupné z: https://doi:10.1111/jocn.12688
- Blackman, I., Papastavrou, E., Vryonides, et al. (2018) Predicting variations to missed nursing care: A three-nation comparison. Journal of Nursing Management, 26(1), 33-41. Dostupné z: https://doi:10.1111/ jonm.12514
- Bragadóttir H. & Kalisch B.J. (2018) Comparison of reports of missed nursing care: Registered Nurses vs. practical nurses in hospitals. Scandinavian Journal of Caring Science, 32(3), 1227-1236. Dostupné z: https://doi.org./10.1111/scs.12570
- Dhaini S. R, Zúñiga F, Ausserhofer D, et al. (2017) Are nursing home care workers’ health and presenteeism associated with implicit rationing of care? A cross-sectional multi-site study. Geriatric Nursing, 38(1), 33-38. Dostupné z: https://doi.org./10.1016/j.gerinurse.2016.07.003 Gurková E, Adamkovič M, Jones T, et al. (2020) Factor analysis, validity of the perceived implicit rationing of nursing care instrument and prevalence and patterns of unfinished nursing care in Slovakia. Journal of Nursing Management, 28(8), 2036-2047 Dostupné z: https:// doi:10.1111/jonm.12887
- Harvey C. Thompson S, Pearson M. et al. (2017) Missed nursing care as an „art form“ The contradictions of nurses as carers. Nursing Inquiry, 24(3) e:12180. Dostupné z: https://doi:10.1111/nin.12180 Henderson J, Willis E, Xia L, et al. (2017) Missed care in residential aged care in Australia: An exploratory study. Australian Collegian of Nursing, 24(5), 411–416. Dostupné z: https://doi:10.1016/j.colegn.2016.09.001
- Jarošová D, Zeleníková R. (2019) Unfinished nursing care – the first pilot study in the Czech Republic. Journal of nursing and social science related to health and illness. Kontakt, 21(4) 388-394-. Dostupné z: http://doi:.10.32725/kont.2019.048
- Jones T. L. (2014) Validation of the Perceived Implicit Rationing of Nursing Care (PIRNCA) Instrument. Nursing Forum, 49(2), 77-87. Dostupné z: https://doi:10.1111/nuf.12076
- 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. Dostupné z: https://doi.org/10.1016/j.ijnurstu.2015.02.012
- Kalánková D, Suhonen R, Stolt M. et al. (2020) Psychometric testing of perceived implicit rationing of nursing care (PIRNCA). Journal of Advanced Nursing, 76(6), 1469-1482 Dostupné z: https://doi:10.1111/jan.14351 Kalisch B. J. (2006) Missed nursing care: A qualitative study. Journal of Nursing Care Quality 21(4), 306-313.
- Lake E. T (2002) Development of the Practice Environmenr Scale of the Nursing Work Index. Research in nursing &Health. 25 176-188 Dostupné z: https://doi.org/10.1002/nur.100023
- Lake E. T., Staiger D., Edwards E. M. et al. (2018) Nursing Care disparities in neonatal intensive care units. Health Services Reasarch, 53 30073026 Dostupné z: https://doi.org/10.1111/1475-6773.12762
- Lake E. T., French R., O´Rourke K., et al (2019) Linkint the work environment to missed nursing care in labour and delivery. Journal of Advanced Nursing, 28(8), 1901-1908 Dostupné z: https://doi:10.1111/jan.12856 McCauley L., Kirwan M., Riklikiene O. et al. (2020) A scopong review: The role of the nurse manager as represented in the missed care literature. Journal of Advanced Nursing, 28(8), 1770-1782 Dostupné z: https://doi:10.1111/jonm.13011
- Palese A, Ambrosi E, Prosperi L, et al. (2015) Missed nursing care and predicting factors in the Italian medical care setting. Internal and Emergency Medicine,10(6), 693-702. Dostupné z: https://doi:10.1007/ s11739-015-1232
- Papastavrou, E., Andreou P, Tsangari H, et al. (2014). Linking patient satisfaction with nursing care: The case of care rationing – a correlational study. BMC Nursing, 13 (26) Dostupné z: https://org.10.1186/14726955-13-26
- Park S. H., Hanchett M., Ma Ch. (2018) Parctice Environment Charakteristics Associated With Missed Nursing Care. Journal of Nursing Scholarship, 50(6) 722-730. Sigma Theta Tau International. Plevová I. et al. (2018) Ošetřovatelství I. 2. přepracované a doplněné vydání. Praha: Grada.
- Schubert M, Glass T. R, Clarke S. P, et al. (2007) Validation of the Basel extent of rationing of nursing care instrument. Nursing Research, 56(6), 416-424. Dostupné z: https://doi.org/10.1097/01N-
- NR.0000299853.52429.62
- Schubert M, Ausserhofer D, Desmndt M. 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 Studie,
- 50(2), 230-239. Dostupné z: https://doi:10.106/j.injurstu.2012.09.016 Vyhláška 391/2017, o činnostech zdravotnických pracovníků a jiných odborných pracovníků www.mzcr.cz/legislativa/novely-k-zakonuč.96/2004Sb.-Ministerstvozdravotnictví(mzcr.cz)
- Willis E, Carryer J, Harvey C, et al. (2017) Austerity, new public management and missed nursing care in Australia and New Zealand. Journal of Advanced Nursing (John Wiley), 73(12), 3102-3110 Dostupné z: https://doi:10.1111/jan.13380
- Zákon 201/2017, o podmínkách získávání a uznávání způsobilosti k výkonu nelékařských zdravotnických povolání a k výkonu činností souvisejících s poskytováním zdravotní péče www.mzcr.cz/ legislativa/novely-k-zakonuč.96/2004Sb.-Ministerstvozdravotnictví(mzcr.cz)
- Zeleníkova R, Gurková E, & Jarošová D. (2019) Missed nursing care measured by MISSCARE survey – the frist pilot study in the Czech Republic and Slovakai. Central European Journal of Nursing and
- Midwifery, 10(1) 958-966. Dostupné z: https://doi-org./10.15452/CEJ-
- NM.2019.10.0002
- Zeleníkova R, Gurková E, Friganovic A, et al. (2020) Unfinished nursing care in four central European countries. Journal of Nursing Management, 28(8) 1888-1900 Dostupné z: https://doi:10.1111/ jonm.12896
- Zuñiga F., Ausserhofer D., Hames J. et al. (2015) The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes – A cross-sectional study. Journal of Nursing Studies, 25(5) 1463-1474. Dostupné z: https://doi.org/10.1016/j.ijmurstu.2015.05.005
Labels
General practitioner for children and adolescents General practitioner for adultsArticle was published in
General Practitioner
2021 Issue Suplementum 1, díl 2.
Most read in this issue
- The Phenomenon of Rationing Nursing Care in Czech Hospitals – a Pilot Study
- Comparison of Burden and Stress in Parents of Children with a Disability and Parents of Children without a Disability with Regard to Quality of Life
- Role of Nurses in Ensuring Care Quality and Safety Related to Pharmacotherapy
- Odkaz Florence Nightingalové na cestě k moderní péči