Depicting clinical nurses' priority perspectives leading to unfinished nursing care: A pilot Q methodology study

J Nurs Manag. 2020 Nov;28(8):2146-2156. doi: 10.1111/jonm.13036. Epub 2020 Jun 10.

Abstract

Aims: To highlight (a) trends common to all nurses on priorities attributed to interventions, and (b) whether there are profiles of nurses working in the same context who prioritize interventions in a similar way.

Background: The underlying prioritization of interventions leading to unfinished nursing care has been minimally investigated.

Methods: A 2017 pilot Q methodology study. Full-time nurses, with at least 6 months of experience in a surgical unit, were involved. Eleven nurses rated the priority given in daily practice (from -3 as the lowest to +3 as the highest) to 35 Q-sample statements representing nursing care, non-nursing and organisational interventions.

Results: Overall, the intervention receiving the lowest priority was 'Providing patient hygiene', while the highest was 'Answering phone calls'. In the by-person factor analysis (total variance = 60.79%), three profiles of nurses emerged, (a) 'Patient safety-oriented' (variance = 31.66%); (b) 'Nursing task-oriented' (=16.32%); and (c) 'Team process-oriented' (=12.81%).

Conclusions: Three profiles of nurses emerged in the same setting with significant differences both in the statistical order of priorities and in their practical implications.

Implications for nursing management: Understanding levels of prioritization, which are not only affected by the unit but also by sub-groups of nurses who rank priorities in a similar way, can support nurse managers in their role.

Keywords: Q methodology; implicit rationing of nursing care; missed nursing care; non-nursing tasks; nursing interventions; organisational tasks; priority setting; task left undone; unfinished nursing care.

MeSH terms

  • Humans
  • Nurses*
  • Nursing Care*