Ethical elements in priority setting in nursing care: A scoping review.

Area of Science:

• Nursing Ethics
• Healthcare Management
• Patient Care Prioritization

Background:

• Nurses manage multiple patients, necessitating prioritization of care activities.
• Balancing diverse patient needs and expectations challenges nurses' professional and moral values.

Purpose of the Study:

• To explore ethical aspects of nursing care prioritization.
• To illustrate the consequences of prioritization for nurses.

Main Methods:

• Scoping review of empirical research on priority setting, prioritization, and rationing in nursing.
• Analysis of 25 empirical research articles identified from CINAHL and MEDLINE databases.
• Inductive content analysis of selected research articles.

Main Results:

• Nurses engage in priority setting at bedside, unit, organizational, and societal levels.
• Prioritization decisions consider patient needs, task essentiality, care access, bed allocation, fairness, patient groups, disease severity, age, and treatment benefits.
• Negative consequences include moral distress, missed care, and compromised quality of care.

Conclusions:

• Further study is required to understand the ethical elements and root causes of priority setting for nursing staff.
• Prioritization is challenging for nurses, indicating a need for targeted education and support.
• Understanding prioritization processes is crucial for developing effective support systems for nurses.