Περίληψη:
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.
Συγγραφείς:
Suhonen, Riitta
Stolt, Minna
Habermann, Monika
Hjaltadottir,
Ingibjorg
Vryonides, Stavros
Tonnessen, Siri
Halvorsen,
Kristin
Harvey, Clare
Toffoli, Luisa
Scott, P. Anne and
Evridiki, Papastavrou
Chryssoula, Lemonidou
Walter, Sermeus and
Maria, Schubert
Riitta, Suhonen
Olga, Riklikiene
Rengin,
Acaroglu
Panayiota, Andreou
Darijana, Antonic
Dietmar,
Ausserhofer
Christophe, Baret
Helen, Bosch-Leertouwer
Helga,
Bragadottir
Luk, Bruyneel
Karin, Christiansen
Ruta, Ciutiene
and Raul, Cordeiro
Liana, Deklava
Suzanne, Dhaini
Anat,
Drach-Zahavy
Georgios, Eftathiou
Sigal, Ezra
Fuster, Pilan
and Joanna, Gotlib
Elena, Gurkova
Monika, Habermann
Kristin,
Halovsen
Patti, Hamilton
Clare, Harvey
Saima, Hinno and
Ingibjorg, Hjaltadottir
Darja, Jarosova
Terry, Jones and
Raphaela, Kane
Marcia, Kirwan
Helena, Leino-Kilpi
Marcel,
Leppee
Mario, Amorim Lopes
Inga, Millere
Aysel, Ozsaban and
Alvisa, Palese
Elisabeth, Patiraki
Katina, Pavloska
Amanda,
Phelan
Paraschiva, Postolache
Ivana, Prga
Agripina, Rasch
and Diaz Cristobal, Rengel
Christian, Rochefort
Anne, Scott and
Michael, Simon
Renate, Stemmer
Erna, Tichelaar
Luisa,
Toffoli
Siri, Tonnessen
Izabella, Uchmanowicz
Jasminka,
Vuckovic
Eileen, Willis
Lily, Xiao
Renata, Zelenikcova and
Tatjana, Zorcec
RANCARE Consortium COST Action-CA
