Increasing implicit rationing of care in nursing homes: A time-series cross-sectional analysis

Renner, Anja; Ausserhofer, Dietmar; Zúñiga, Franziska; Simon, Michaël; Serdaly, Christine; Favez, Lauriane

doi:10.1016/j.ijnurstu.2022.104320

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…The 15 articles included in the analysis were published between 2010 and 2022, with 12 of the articles published between 2015 and 2022 [ 1 , 2 , 7 , 8 , 12 , 20 – 23 , 23 – 28 ]. The study designs varied from cross-sectional to longitudinal, observational, and quantitative.…”

Section: Resultsmentioning

confidence: 99%

“…Uchmanowicz et al found that nurses with low and moderate levels of life satisfaction, as well as those with a pessimistic or neutral life orientation, had higher scores on the BERCA-R than more optimistic nurses with high levels of life satisfaction [ 8 ]. Finally, Renner et al found that there were overall increases of rationing of care activities over the 5-year period studied, with documentation and social activities most rationed at both measurement points, and a considerable increase in rationing of activities of daily living was observed [ 23 ]. Młynarska et al found that sociodemographic factors did not affect the rationing level of nursing care in the intensive care unit; the average quality of patient care was 6.05/10 points, while the average job satisfaction rating was 7.13/10 points [ 25 ].…”

Section: Resultsmentioning

confidence: 99%

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The Impact of Rationing Nursing Care on Patient Safety: A Systematic Review

Uchmanowicz,

Lisiak,

Wleklik

et al. 2023

Med Sci Monit

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Background Rationing of nursing care (RONC) has been associated with poor patient outcomes and is a growing concern in healthcare. The aim of this systematic study was to investigate the connection between patient safety and the RONC. Material/Methods A thorough search of electronic databases was done to find research that examined the relationship between restricting nurse services and patient safety. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two reviewers (M.L. and A.P.) independently screened the titles and abstracts, and full-text articles were assessed for eligibility. Data were extracted, and a quality assessment was performed using appropriate techniques. Results A total of 15 studies met the inclusion criteria. The studies included in the review demonstrated a correlation between rationing of nursing care and patient safety. The results of these studies revealed that there is an inverse relationship between rationing of nursing care and patient safety. The review found that when nursing care is rationed, there is a higher incidence of falls, medication errors, pressure ulcers, infections, and readmissions. In addition, the review identified that the work characteristics of nurses, such as workload, staffing levels, and experience, were associated with RONC. Conclusions RONC has a negative impact on patient safety outcomes. It is essential for healthcare organizations to implement effective strategies to prevent the RONC. Improving staffing levels, workload management, and communication amo0ng healthcare providers are some of the strategies that can support this.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

The Impact of Rationing Nursing Care on Patient Safety: A Systematic Review

Uchmanowicz,

Lisiak,

Wleklik

et al. 2023

Med Sci Monit

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“…At the same time, however, our outcomes (depressive symptoms, responsive behaviors, and unindicated antipsychotic use) tap into various aspects of social care and support, areas that are typically deprioritized in favor of physical care activities in the resource-constrained work environments of the NH sector ( Ludlow et al, 2021 ; Renner et al, 2022 ). One time-motion study found that care aides spent over half of their shift undertaking personal care tasks, typically in 1- to 3-minute segments with frequent interruptions, and nearly one-quarter of their shift entailed work that did not involve residents ( Mallidou et al, 2013 ).…”

Section: Discussionmentioning

confidence: 99%

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes

Gruneir,

Chamberlain,

Jensen

et al. 2023

Med Care Res Rev

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While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014–2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work–life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.0) data were obtained on all residents in the sampled NHs during this time and included a unit identifier for each resident. We used multi-level models to test associations between the MBI emotional exhaustion and cynicism sub-scales reported by care aides and the resident outcomes of antipsychotics without indication, depressive symptoms, and responsive behaviors among residents on units. In 2019/2020, our sample included 3,547 care aides and 10,117 residents in 282 units. The mean frequency of emotional exhaustion and cynicism across units was 43% and 50%, respectively. While residents frequently experienced antipsychotics without indication 1,852 (18.3%), depressive symptoms 2,089 (20.7%), and responsive behaviors 3,891 (38.5%), none were found to be associated with either emotional exhaustion or cynicism among care aides.

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“…The authors believe that the rationing of nursing care is disturbing, especially considering the potential negative effect both on the inpatients as well as the personnel. In the opinion of the authors, regular monitoring of rationing of nursing care should be considered [42]. Willis and Brady conducted a literature review with respect to the effects of rationing of nursing care in Europe, the USA and Oceania in the period 2010-2020.…”

Section: Rationing Of Nursing Carementioning

confidence: 99%

Assessment of The Effect of Stress, Sociodemographic Variables and Work-Related Factors on Rationing of Nursing Care

Schneider-Matyka

Świątoniowska-Lonc²,

Polański

et al. 2023

IJERPH

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(1) Rationing of nursing care is withholding, limiting or not fulfilling the necessary nursing activities for patients. It may have a negative effect on patient safety and the quality of care. The aim of the present paper is the assessment of the effect of stress on the rationing of nursing care. (2) The current research has a cross-sectional, observational design. The study sample comprised 567 nurses. The following questionnaires were used in the study PIRNCA and PSS-10. (3) It was demonstrated that nurses with a high level of perceived stress rationed nursing care to a greater extent and showed lower assessment of nursing care and lower job satisfaction in comparison with nurses with average and low levels of perceived stress. (4) 1. Stress in nurses has a negative effect on rationing of nursing care and job satisfaction. It is recommended that actions aimed at developing effective stress coping skills be implemented as early as at the stage of training to become a nurse. 2. Factors such as marital status, sex, form of employment, place of employment and the level of professional burnout syndrome may have an influence on the level of experienced stress. In turn, the level of experienced stress, marital status, education, place of work as well as the place of residence may have an effect on rationing of nursing care and, consequently, affect the quality of care.

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Increasing implicit rationing of care in nursing homes: A time-series cross-sectional analysis

Cited by 10 publications

References 30 publications

The Impact of Rationing Nursing Care on Patient Safety: A Systematic Review

The Impact of Rationing Nursing Care on Patient Safety: A Systematic Review

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes

Assessment of The Effect of Stress, Sociodemographic Variables and Work-Related Factors on Rationing of Nursing Care

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