Inadequate number of staff and other reasons for implicit rationing of nursing care across hospital types and units.
Renáta Zeleníková, Darja Jarošová, Eva Mynaříková and 2 others
PMID 37209016WHAT IT FOUND
Nurses in Czech hospitals identified inadequate staffing and unexpected patient admissions as the primary reasons for missing care.
Medical unit nurses rated these resource issues as more significant than surgical nurses, while university hospitals reported higher staffing shortages than non-university sites.
Key findings
01The most significant reasons for rationing nursing care were inadequate number of staff, inadequate number of assistive personnel, and unexpected patient admission and discharge.
02Nurses in medical units rated almost all reasons for rationing care as more significant than nurses in surgical units, except for communication problems with doctors.
03Inadequate number of staff and assistive personnel were rated as more significant reasons for rationing by nurses in university hospitals compared to non-university hospitals.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was non-randomised, which may limit the generalisability of the findings to all nurses in the Czech Republic. The study included both general nurses and practical nurses, who have different scopes of practice, potentially introducing heterogeneity in how they perceive care rationing. Data collection was interrupted for three months due to the COVID-19 pandemic lockdown, which may have affected the consistency of the data or the context in which nurses were working during the remaining collection period.
Declared interests
The study was supported by the Ministry of Health of the Czech Republic. The authors declared no conflict of interest.
The easy way to misread this
Do not interpret the higher ratings of staffing shortages in university hospitals as evidence that non-university hospitals have adequate staffing. Nurses in non-university hospitals rated other factors, such as unexpected admissions and patient deterioration, as more significant contributors to missed care, indicating different resource pressures rather than a simple lack of staff.