Trends and variability of implicit rationing of care across time and shifts in an acute care hospital : a longitudinal study
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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.
Dhaini , S R , Simon , M , Ausserhofer , D , Abed Al Ahad , M , Elbejjani , M , Dumit , N & Huijer , H A-S 2020 , ' Trends and variability of implicit rationing of care across time and shifts in an acute care hospital : a longitudinal study ' , Journal of Nursing Management , vol. Early View . https://doi.org/10.1111/jonm.13035
Journal of Nursing Management
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
DescriptionThe proposed study was funded for 2 years (2018‐2020) by the Medical Practice Plan, Faculty of Medicine, American University of Beirut, Lebanon.
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