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