Advancing the science of unfinished nursing care: Exploring the benefits of cross‐disciplinary knowledge exchange, knowledge integration and transdisciplinarity

Abstract

Aims The aims of this paper are to explore the role of cross‐disciplinary knowledge exchange and integration in advancing the science of unfinished nursing care and to offer preliminary guidance for theory development activities for this growing international community of scholars. Background Unfinished nursing care, also known as missed care or rationed care is a highly prevalent problem with negative consequences for patients, nurses and healthcare organizations around the world. It presents as a ‘wicked’ sustainability problem resulting from structural obstacles to effective resource allocation that have been resistant to conventional solutions. Research activity related to this problem is on the rise internationally but is hindered by inconsistencies in conceptualizations of the problem and lack of robust theory development around the phenomenon. A unified conceptual framework is needed to focus scholarly activities and facilitate advancement of a robust science of unfinished nursing care. Design Discussion paper. Data Sources This discussion paper is based on our own experiences in international and interdisciplinary research partnerships related to unfinished nursing care. These experiences are placed in the context of both classic and current literature related to the evolution of scientific knowledge. Implications for Nursing The problem of unfinished nursing care crosses multiple scientific disciplines. It is imperative that the community of scholars interested in solving this wicked problem engage in meaningful cross‐disciplinary knowledge integration and move towards transdisciplinarity. Conclusion Metatheorizing guided by structuration theory should be considered as a strategy to promote transdiciplinarity around the problem of unfinished nursing care.

<p>Missed Care from the Patient’s Perspective – A Scoping Review</p>

“…However, there is currently a lack of a theoretical framework and common terminology to describe missed care as it remains unclear whether an understanding exists about how it occurs or whether the causation and response to missed care are similar across different health-care environments; development of a theoretical framework to describe and understand missed care is thus highly needed. 19 Missed care is an ethical issue challenging nurses' professional and moral values, consequently leading to imbalance between patients' needs and available and/or scarce resources. Therefore, nurses need to prioritize their work, and missed care is an outcome of this prioritization process.…”

Systems, economics, and neoliberal politics: Theories to understand missed nursing care

“…Missed care is characterized as one of society's “wicked problems” that warrants a transdisciplinary approach to inquiry (Jones, Willis, Amorim‐Lopes, & Drach‐Zahavy, ). Moreover, Jones et al () encouraged the community of scholars to move toward a shared understanding of the phenomenon through cross‐disciplinary knowledge exchange guided by a structuration theory framework (Giddens, ).…”

“…Missed care is characterized as one of society's “wicked problems” that warrants a transdisciplinary approach to inquiry (Jones, Willis, Amorim‐Lopes, & Drach‐Zahavy, ). Moreover, Jones et al () encouraged the community of scholars to move toward a shared understanding of the phenomenon through cross‐disciplinary knowledge exchange guided by a structuration theory framework (Giddens, ). We intend to extend this metatheoretical exploration and contribute to cross‐disciplinary knowledge exchange by presenting missed care through different disciplinary lenses: systems theory, economic theory, and neoliberal political economy theory.…”

How the Lagged and Accumulated Effects of Stress, Coping, and Tasks Affect Mood and Fatigue during Nurses’ Shifts

“…It may be concluded that the pressure of care and tasks that require immediacy is detrimental to the direct care tasks, to which the nurse may dedicate less time than they consider necessary. The explanation for this result can be found in the pressures on time usage, which could precipitate implicit rationing by establishing clinical priorities in the nursing setting, resulting in staff feeling that some care tasks may have been left undone, a situation referred to as “unfinished nursing care” [ 70 ]. For nurses, satisfaction in daily task accomplishment is negatively associated with changes in negative affect at the end of the shift.…”