Validation of the Basel Extent of Rationing of Nursing Care Instrument

Schubert, Maria; Glass, Tracy R.; Clarke, Sean P.; Schaffert-Witvliet, Bianca; Geest, Sabina De

doi:10.1097/01.nnr.0000299853.52429.62

Cited by 237 publications

(448 citation statements)

References 18 publications

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“…Most studies measured missed care with nurse or patient surveys that have been widely used in the missed care literature, namely survey from the International Hospital Outcomes Consortium [IHOC]/RN4CAST (Sermeus et al., 2011); MISSCARE (Kalisch, 2006) and the Basel Extent of Rationing of Nursing Care: BERNCA (Schubert, Glass, Clarke, Schaffert‐Witvliet, & De Geest, 2007). Three studies were secondary analyses of the large RN4CAST study conducted across 15 European countries (Ausserhofer et al., 2013; Ball, Murrells, Rafferty, Morrow, & Griffiths, 2014; Bruyneel et al., 2015), where authors analysed and reported data from individual countries.…”

Section: Resultsmentioning

confidence: 99%

What impact does nursing care left undone have on patient outcomes? Review of the literature

Recio‐Saucedo

Dall’Ora

Maruotti

et al. 2017

Journal of Clinical Nursing

327

304

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Aims and objectivesSystematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes.BackgroundA considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear.DesignSystematic review.MethodsWe searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review.ResultsFourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged.ConclusionsThe review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self‐reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required.Relevance to clinical practiceAlthough nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.

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Section: Resultsmentioning

confidence: 99%

What impact does nursing care left undone have on patient outcomes? Review of the literature

Recio‐Saucedo

Dall’Ora

Maruotti

et al. 2017

Journal of Clinical Nursing

327

304

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“…In resource-constrained work environments, activities requiring interaction with patients can fall by the wayside (Aiken et al, 2001;Kalisch, Landstrom, & Williams, 2009;Lucero, Lake, & Aiken, 2009;Schubert, Glass, Clarke, Schaffert-Witvliet, & De Geest, 2007).…”

mentioning

confidence: 99%

Organizational Climate and Hospital Nurses' Caring Practices: A Mixed‐Methods Study

Roch

Dubois

Clarke

2014

Research in Nursing & Health

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Organizational climate in healthcare settings influences patient outcomes, but its effect on nursing care delivery remains poorly understood. In this mixed-methods study, nurse surveys (N = 292) were combined with a qualitative case study of 15 direct-care registered nurses (RNs), nursing personnel, and managers. Organizational climate explained 11% of the variation in RNs' reported frequency of caring practices. Qualitative data suggested that caring practices were affected by the interplay of organizational climate dimensions with patients and nurses characteristics. Workload intensity and role ambiguity led RNs to leave many caring practices to practical nurses and assistive personnel. Systemic interventions are needed to improve organizational climate and to support RNs' involvement in a full range of caring practices.

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“…Missed nursing care has been linked to negative patient outcomes (Schubert, Glass, Scaffert-Wiltvliet & De Geest., 2009) and attributed to a variety of causes from the work environment, to patient care demands and staffing issues (Kalisch, Doumit, Lee & Zein 2013;Papastavrou, Panayiota & Georgios, 2013;Aitken, Clarke & Sloane, 2002;Needleman, Buerhaus, Mattke, Srewart & Zelevinsky, 2002). Current research suggests that when a nurse's work load increases, there is less time to care for individual patients (Schubert, Glass, Schaffert-Witvliet & De Geest 2008).…”

Section: Introductionmentioning

confidence: 99%

Nurses and midwives perceptions of missed nursing care – A South Australian study

et al. 2015

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Validation of the Basel Extent of Rationing of Nursing Care Instrument

Abstract: Initial evidence of the validity and reliability of the BERNCA instrument was provided.

Cited by 237 publications

References 18 publications

What impact does nursing care left undone have on patient outcomes? Review of the literature

What impact does nursing care left undone have on patient outcomes? Review of the literature

Organizational Climate and Hospital Nurses' Caring Practices: A Mixed‐Methods Study

Nurses and midwives perceptions of missed nursing care – A South Australian study

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