Aim: The main aim of the research was to describe and compare unfinished nursing care in selected European countries. Background: The high prevalence of unfinished nursing care reported in recently published studies, as well as its connection to negative effects on nurse and patient outcomes, has made unfinished care an important phenomenon and a quality indicator for nursing activities. Methods: A cross-sectional descriptive study was undertaken. Unfinished nursing care was measured using the Perceived Implicit Rationing of Nursing Care questionnaire (PIRNCA). The sample included 1,353 nurses from four European countries (Croatia, the Czech Republic, Poland and Slovakia). Results: The percentage of nurses leaving one or more nursing activities unfinished ranged from 95.2% (Slovakia) to 97.8% (Czech Republic). Mean item scores on the 31 items of the PIRNCA in the total sample ranged from 1.13 to 1.92. Unfinished care was significantly associated with the type of hospital and quality of care. Conclusion: The research results confirmed the prevalence of unfinished nursing care in the countries surveyed. Implications for Nursing Management: The results are a useful tool for enabling nurse managers to look deeper into nurse staffing and other organizational issues that may influence patient safety and quality of care.

Background: Burnout is a psychological, work-related syndrome associated with long-term exposure to emotional and interpersonal stressors in the workplace. Burnout syndrome in nurses is often caused by an imbalance between work requirements and preparation and fitness for work, a lack of control, insufficient performance recognition and a prolonged exposure to stress. Aim: The aims of this study were to explore the associations between levels of burnout syndrome, coping mechanisms and job satisfaction in critical care nurses in multivariate modelling process. A specific aim was also to explore whether coping and job satisfaction in critical care nurses are gender related. Methods: A cross-sectional multicentre study was conducted in a convenience sample of 620 critical care nurses from five university hospitals in Croatia in 2017. The data were collected using the Maslach Burnout Inventory and the Ways of Coping and Job Satisfaction Scale together with the nurses’ demographic profiles and were analysed using a multivariable model. Results: The results showed no significant association between gender, coping mechanisms and job satisfaction. However, significant negative associations between burnout and job satisfaction (OR = 0.01, 95%CI = 0.00–0.02, p < 0.001) and positive association between burnout and passive coping (OR = 9.93, 95%CI = 4.01–24.61, p < 0.001) were found. Conclusion: The association between job satisfaction and burnout in nurses urges hospital management teams to consider actions focused on job satisfaction, probably modifications of the work environment. Given that passive coping may increase the incidence of burnout, it is recommendable for active coping to be implemented in nurses’ training programmes as an essential element of capacity building aimed at reducing the incidence of burnout in nurses.

BackgroundNursing shortages, the substitution of practical nurses for registered nurses, an ageing workforce, the decreasing number of nurse graduates and the increasing migration of young nurses are important factors associated with the hospital safety climate in Central European countries.AimsThe aim of the study was to investigate nurses’ perceptions of the safety climate in four selected central European countries (Croatia, the Czech Republic, Poland and Slovakia) and to determine the relationship between safety climate and unfinished nursing care.MethodsA cross‐sectional study was used. The sample consisted of 1353 European nurses from four countries. Instruments used were the Hospital Survey on Patient Safety Culture and the Perceived Implicit Rationing of Nursing Care. Data were analysed using descriptive statistics and multiple regression analyses.ResultsSignificant differences were found between countries in all unit/hospital/outcome dimensions. ‘Perceived Patient Safety’ and ‘Reporting of Incident Data’ were associated with aspects of ‘Organizational Learning’ and ‘Feedback and Communication about Error’. Higher prevalence of unfinished nursing care is associated with more negative perceptions of patient safety climate.ConclusionsCross‐cultural comparisons allow us to examine differences and similarities in safety dimensions across countries. The areas with potential for initiating strategies for improvement in all four countries are ‘Staffing’, ‘Non‐punitive Response to Error’ and ‘Teamwork across Hospital Units’.Implications for nursing and health policy‘Feedback and Communicating about Error’ and ‘Organizational Learning ‐ Continuous Improvement’ were the main predictors of ‘Overall Perception of Patient Safety’ and ‘Reporting of Incident Data’. Therefore, nurse managers should focus on how to empower nurses in these areas in order to foster a no‐blame culture and effective reporting. In addition, it is important for policymakers to update nursing education standards in order to address patient safety.

Aim: To examine Croatian nurses' perception of implicit nursing care rationing and the patient safety culture from the perspective of acute care hospital staff. Background: In the past three decades, the Croatian health system has undergone numerous transformations driven by geopolitical, legal, financial, demographic, scientific and technological progress. These changes have led to systemic changes in the structure, organisation, financing and delivery of health care, and thus, of nursing care. Methods: A cross-sectional study of 438 nurses was conducted at four university hospitals in Croatia, based on the Perceived Implicit Rationing of Nursing Care Questionnaire. Results: A lower assessment of the quality of care in the unit is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r =-.379, p < .001. A lower satisfaction with the current workplace is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = −.432, p < .001. Conclusion: The perception of nurses in Croatia indicates that the implications of nursing care rationing and dissatisfaction with their post in acute care hospital units are closely related to poor quality of nursing care provided to patients. Implications for Nursing Management: Based on these results, nurse managers should take their nurses' perceptions of implicit nursing care rationing into consideration in order to develop strategies to improve nursing care delivery, nursing satisfaction and, consequently, better nursing care quality. K E Y W O R D S acute hospital, implicit rationing, nurses' perception, nursing care | 2231 FRIGANOVIC et Al. How to cite this article: Friganovic A, Režić S, Kurtović B, et al. Nurses' perception of implicit nursing care rationing in Croatia-A cross-sectional multicentre study.