Trends and variability of implicit rationing of care across time and shifts in an acute care hospital: a longitudinal study

Suzanne R. Dhaini, Michael Simon, Dietmar Ausserhofer, Mary Abed Al Ahad, Martine Elbejjani, Nuhad Dumit, Huda Abu-Saad Huijer

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)
4 Downloads (Pure)

Abstract

Background

Implicit rationing of nursing care is associated with work environment factors. Yet a deeper understanding of trends and variability is needed.

Aims

To explore the trends and variability of rationing of care per shift between individual nurses, services over time, and its relationship with work environment factors.

Methods

Longitudinal study including 1,329 responses from 90 nurses. Intraclass correlation coefficients (ICC) were computed to examine variability of rationing per shift between individual nurses, services, and data collection time; generalized linear mixed models were used to explore the relationship with work environment factors.

Results

Percentage of rationing of nursing activities exceeded 10% during day and night shifts. Significant variability in rationing items was observed between nurses, with ICCs ranging between 0.20 and 0.59 in day shifts, and between 0.35 and 0.85 in night shifts. Rationing of care was positively associated with nurses’ self‐perceived workload in both shifts, but not with patient‐to‐nurse ratios.

Conclusion

Most variability in rationing over time was explained by the individual.

Original languageEnglish
JournalJournal of Nursing Management
VolumeEarly View
Early online date29 Jun 2020
DOIs
Publication statusE-pub ahead of print - 29 Jun 2020

Keywords

  • Hospital
  • Longitudinal
  • Nursing
  • Quality of care
  • Rationing of care

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