@article{3182295,
    title = "Ethical elements in priority setting in nursing care: A scoping review",
    author = "Suhonen, Riitta and Stolt, Minna and Habermann, Monika and Hjaltadottir, and Ingibjorg and Vryonides, Stavros and Tonnessen, Siri and Halvorsen, and Kristin and Harvey, Clare and Toffoli, Luisa and Scott, P. Anne and and Evridiki, Papastavrou and Chryssoula, Lemonidou and Walter, Sermeus and and Maria, Schubert and Riitta, Suhonen and Olga, Riklikiene and Rengin, and Acaroglu and Panayiota, Andreou and Darijana, Antonic and Dietmar, and Ausserhofer and Christophe, Baret and Helen, Bosch-Leertouwer and Helga, and Bragadottir and Luk, Bruyneel and Karin, Christiansen and Ruta, Ciutiene and and Raul, Cordeiro and Liana, Deklava and Suzanne, Dhaini and Anat, and Drach-Zahavy and Georgios, Eftathiou and Sigal, Ezra and Fuster, Pilan and and Joanna, Gotlib and Elena, Gurkova and Monika, Habermann and Kristin, and Halovsen and Patti, Hamilton and Clare, Harvey and Saima, Hinno and and Ingibjorg, Hjaltadottir and Darja, Jarosova and Terry, Jones and and Raphaela, Kane and Marcia, Kirwan and Helena, Leino-Kilpi and Marcel, and Leppee and Mario, Amorim Lopes and Inga, Millere and Aysel, Ozsaban and and Alvisa, Palese and Elisabeth, Patiraki and Katina, Pavloska and Amanda, and Phelan and Paraschiva, Postolache and Ivana, Prga and Agripina, Rasch and and Diaz Cristobal, Rengel and Christian, Rochefort and Anne, Scott and and Michael, Simon and Renate, Stemmer and Erna, Tichelaar and Luisa, and Toffoli and Siri, Tonnessen and Izabella, Uchmanowicz and Jasminka, and Vuckovic and Eileen, Willis and Lily, Xiao and Renata, Zelenikcova and and Tatjana, Zorcec and RANCARE Consortium COST Action-CA",
    journal = "International Journal of Nursing Studies",
    year = "2018",
    volume = "88",
    pages = "25-42",
    publisher = "PERGAMON-ELSEVIER SCIENCE LTD",
    issn = "0020-7489",
    doi = "10.1016/j.ijnurstu.2018.08.006",
    keywords = "Ethics; Nurse; Nursing care; Priority setting; Prioritisation;
Rationing; Scoping review",
    abstract = "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."
}