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

doi:10.1111/jonm.13035

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

School of Geography & Sustainable Development

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

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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 language	English
Journal	Journal of Nursing Management
Volume	Early View
Early online date	29 Jun 2020
DOIs	https://doi.org/10.1111/jonm.13035
Publication status	E-pub ahead of print - 29 Jun 2020

Keywords

Hospital
Longitudinal
Nursing
Quality of care
Rationing of care

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10.1111/jonm.13035

Dhaini_2020_JNM_Rationingofcare_AAM
Copyright © 2020 John Wiley & Sons Ltd. This work has been made available online in accordance with publisher policies or with permission. Permission for further reuse of this content should be sought from the publisher or the rights holder. This is the author created accepted manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at https://doi.org/10.1111/jonm.13035
Accepted author manuscript, 13.2 MB

Cite this

@article{979e5cda33f6485999ba0d05bfe1cf65,

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

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{\textquoteright} 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. ",

keywords = "Hospital, Longitudinal, Nursing, Quality of care, Rationing of care",

author = "Dhaini, {Suzanne R.} and Michael Simon and Dietmar Ausserhofer and {Abed Al Ahad}, Mary and Martine Elbejjani and Nuhad Dumit and Huijer, {Huda Abu-Saad}",

note = "The proposed study was funded for 2 years (2018‐2020) by the Medical Practice Plan, Faculty of Medicine, American University of Beirut, Lebanon.",

year = "2020",

month = jun,

day = "29",

doi = "10.1111/jonm.13035",

language = "English",

volume = "Early View",

journal = "Journal of Nursing Management",

issn = "0966-0429",

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T1 - Trends and variability of implicit rationing of care across time and shifts in an acute care hospital

T2 - a longitudinal study

AU - Dhaini, Suzanne R.

AU - Simon, Michael

AU - Ausserhofer, Dietmar

AU - Abed Al Ahad, Mary

AU - Elbejjani, Martine

AU - Dumit, Nuhad

AU - Huijer, Huda Abu-Saad

N1 - The proposed study was funded for 2 years (2018‐2020) by the Medical Practice Plan, Faculty of Medicine, American University of Beirut, Lebanon.

PY - 2020/6/29

Y1 - 2020/6/29

N2 - 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.

AB - 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.

KW - Hospital

KW - Longitudinal

KW - Nursing

KW - Quality of care

KW - Rationing of care

U2 - 10.1111/jonm.13035

DO - 10.1111/jonm.13035

M3 - Article

SN - 0966-0429

VL - Early View

JO - Journal of Nursing Management

JF - Journal of Nursing Management

ER -

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

Abstract

Keywords

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