Aim: To gain an in-depth understanding of the variations and trends of implicit rationing of nursing care, of its associated factors and of its relation to with nurse and patient outcomes.
Background: Maintaining and improving the quality of nursing care and patient safety have been the focus of health services researchers over the last decade. Cross-sectional studies have showed the magnitude of implicit rationing of nursing care and its associations with negative patient and nurse outcomes.
Design: Observational longitudinal study.
Method: Two-year funded study (between 2018-2020), including a sample of 317 Registered Nurses working on 19 units in two large Lebanese urban hospitals. The study included a cross-sectional baseline survey followed by multiple follow-up assessments over 90 days. The repeated measurements on each of the units include repeated surveys on nurses' rationing of care, hospital administration reported nurse-sensitive indicators, nurse staffing levels, and patient mortality data.
Discussion: The study results will describe variations and trends of implicit rationing of nursing care in hospital units over time and whether and which elements of the nurses' work environment are associated with these variations. Data will inform on the impact of implicit rationing of care on patient and nurse outcomes. These data are needed to advance future planning and interventional research to efficiently reduce rationing of nursing care and improve the quality of care.
Impact: Generating new knowledge (variations and trends) on the association between rationing of care and other element of nurses' work environment and nurse and patient outcomes.
目的: 深入了解隐性定量护理的变化趋势、相关因素及其与护士和患者的护理结果之间的关系。 背景: 过去十年,维持和改善护理质量和患者安全一直是卫生服务研究人员关注的焦点。横断研究已经证实了隐性定量护理的重要性及其与患者和护士消极的护理结果之间的关系。 设计: 纵向观察研究 方法: 开展为期两年的资金支持研究(2018-2020年),包括在黎巴嫩两家大型城市医院的19个单位工作的317名注册护士的研究样本。该研究包括一项横断面基线调查,以及在调查后的90天内进行重复跟踪评估。对每个医院的重复跟踪评估包括对其护士定量配给、医院管理部门记录的护士敏感指标、护士配备水平以及患者死亡率数据的重复调查。 讨论: 研究结果将显示出不同时间所有医院单位内隐性定量护理的变化和趋势,以及护士工作环境中的因素与这些变化和趋势的关联性,哪些因素与这些变化和趋势具有关联性。数据将会显示隐性定量护理对患者和护士护理结果的影响。为有效减少定量护理,提高护理质量,这些数据对促进未来规划和介入研究而言都是不可或缺的。 影响: 为定量护理与护士工作环境的其他因素以及护士和患者的护理结果之间的关系提供新的理论知识(变化和趋势)。.
Keywords: Registered Nurse; hospital; implicit rationing of care; longitudinal design; missed care; unfinished nursing care; work environment.
© 2019 John Wiley & Sons Ltd.