Rationing of nursing care: A concept analysis

Area of Science:

• Nursing Science
• Healthcare Management
• Quality Improvement

Background:

• Rationing of nursing care (RONC) is a critical process factor impacting patient care quality.
• The concept of RONC lacks clear definition and comprehensive analysis.
• Existing views on RONC are varied, necessitating a structured conceptual exploration.

Purpose of the Study:

• To conduct a concept analysis of rationing of nursing care using Walker and Avant's eight-step method.
• To define the meaning, attributes, dimensions, antecedents, and consequences of RONC.
• To develop a theoretical definition and conceptual model for RONC.

Main Methods:

• Literature search across major databases (PubMed, Web of Science, Scopus, etc.) with no date limitations.
• Inclusion of qualitative and quantitative studies on RONC published in English and open-access.
• Analysis of 33 relevant articles using Walker and Avant's concept analysis framework.

Main Results:

• Identified four defining attributes of RONC: duty of care, problem-solving in care delivery, decision-making/prioritization, and outcomes.
• Determined antecedents of RONC across nurse-related, organization-related, care-related, and patient-related factors.
• Developed a theoretical definition and a conceptual model for RONC.

Conclusions:

• The identified attributes, antecedents, and consequences provide a foundational understanding of RONC.
• Findings can inform nursing education, research, and organizational planning to address care rationing.
• A clearer conceptualization of RONC is essential for improving nursing practice and patient outcomes.