6 research outputs found
Understanding the concept of missed nursing care from a cross-cultural perspective
Aims: To investigate how nursing experts and experts from other health professions understand the concept of rationing/missed/unfinished nursing care and how this is compared at a cross-cultural level. Design: The mixed methods descriptive study. Methods: The semi-structured questionnaires were sent to the sample of 45 scholars and practitioners from 26 countries. Data were collected from November 2017–February 2018. Results: Assigning average cultural values to participants from each country revealed three cultural groups: high individualism-high masculinity, high individualism-low masculinity and low individualism-medium masculinity. Content analysis of the findings revealed three main themes, which were identified across cultural clusters: (a) projecting blame for the phenomenon: Blaming the nurse versus blaming the system; (b) intentionality versus unintentionality; and (c) focus on nurses in comparison to focus on patients. Conclusion: Consistent differences in the understanding of missed nursing care can be understood in line with the nation's standing on two main cultural values: individualism and masculinity. Impact: The findings call for scholars' caution in interpreting missed nursing care from different cultures, or in comparing levels and types of missed nursing tasks across nations. The findings further indicated that mimicking interventions to limit missed nursing care from one cultural context to the other might be ineffective. Interventions to mitigate the phenomenon should be implemented thoughtfully, considering the cultural aspects
Advancing the science of unfinished nursing care: Exploring the benefits of cross‐disciplinary knowledge exchange, knowledge integration and transdisciplinarity
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
Understanding the concept of missed nursing care from a cross-cultural perspective
Aims To investigate how nursing experts and experts from other health
professions understand the concept of rationing/missed/unfinished
nursing care and how this is compared at a cross-cultural level. Design
The mixed methods descriptive study. Methods The semi-structured
questionnaires were sent to the sample of 45 scholars and practitioners
from 26 countries. Data were collected from November 2017-February 2018.
Results Assigning average cultural values to participants from each
country revealed three cultural groups: high individualism-high
masculinity, high individualism-low masculinity and low
individualism-medium masculinity. Content analysis of the findings
revealed three main themes, which were identified across cultural
clusters: (a) projecting blame for the phenomenon: Blaming the nurse
versus blaming the system; (b) intentionality versus unintentionality;
and (c) focus on nurses in comparison to focus on patients. Conclusion
Consistent differences in the understanding of missed nursing care can
be understood in line with the nation's standing on two main cultural
values: individualism and masculinity. Impact The findings call for
scholars' caution in interpreting missed nursing care from different
cultures, or in comparing levels and types of missed nursing tasks
across nations. The findings further indicated that mimicking
interventions to limit missed nursing care from one cultural context to
the other might be ineffective. Interventions to mitigate the phenomenon
should be implemented thoughtfully, considering the cultural aspects
Ethical elements in priority setting in nursing care: A scoping review
Background: Nurses are often responsible for the care of many patients
at the same time and have to prioritise their daily nursing care
activities. Prioritising the different assessed care needs and managing
consequential conflicting expectations, challenges nurses' professional
and moral values.
Objective: To explore and illustrate the key aspects of the ethical
elements of the prioritisation of nursing care and its consequences for
nurses.
Design, data sources and methods: A scoping review was used to analyse
existing empirical research on the topics of priority setting,
prioritisation and rationing in nursing care, including the related
ethical issues. The selection of material was conducted in three stages:
research identification using two data bases, CINAHL and MEDLINE. Out of
2024 citations 25 empirical research articles were analysed using
inductive content analysis.
Results: Nurses prioritised patient care or participated in the
decision-making at the bedside and at unit, organisational and at
societal levels. Bedside priority setting, the main concern of nurses,
focused on patients' daily care needs, prioritising work by essential
tasks and participating in priority setting for patients' access to
care. Unit level priority setting focused on processes and decisions
about bed allocation and fairness. Nurses participated in organisational
and societal level priority setting through discussion about the
priorities. Studies revealed priorities set by nurses include
prioritisation between patient groups, patients having specific
diseases, the severity of the patient's situation, age, and the
perceived good that treatment and care brings to patients. The negative
consequences of priority setting activity were nurses' moral distress,
missed care, which impacts on both patient outcomes and nursing
professional practice and quality of care compromise.
Conclusions: Analysis of the ethical elements, the causes, concerns and
consequences of priority setting, need to be studied further to reveal
the underlying causes of priority setting for nursing staff.
Prioritising has been reported to be difficult for nurses. Therefore
there is a need to study the elements and processes involved in order to
determine what type of education and support nurses require to assist
them in priority setting
Ethical elements in priority setting in nursing care: A scoping review
Background: Nurses are often responsible for the care of many patients at the same time and have to prioritise their daily nursing care activities. Prioritising the different assessed care needs and managing consequential conflicting expectations, challenges nurses' professional and moral values
Advancing the science of unfinished nursing care: Exploring the benefits of cross-disciplinary knowledge exchange, knowledge integration and transdisciplinarity
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