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Prioritization decision-making of care in nursing homes: A qualitative study
Pauliina Hackman1, Arja Häggman-Laitila1, Marja Hult1,2
1University of Eastern Finland.
Nurses in nursing homes make difficult prioritization decisions due to workload and lack of support, often concealing unfinished care. Addressing this hidden issue is crucial for improving care quality and nurse well-being.
Area of Science:
- Nursing
- Healthcare Management
- Ethics in Care
Background:
- Prioritization decision-making is a complex ethical challenge for nurses, particularly in nursing homes.
- This phenomenon, concerning unfinished nursing care, is understudied and can impact patient services.
- Increased workload and awareness of consequences are associated with these critical decisions.
Purpose of the Study:
- To describe the process of prioritization decision-making concerning unfinished nursing care in nursing homes.
- To explore the factors influencing nurses' ethical judgments in complex care situations.
Main Methods:
- A qualitative descriptive study utilizing individual theme interviews.
- Data were collected from 23 nurses in Finnish nursing homes between June 2022 and February 2023.
- Inductive content analysis was employed to analyze the interview data.
Main Results:
- Nurses' prioritization decisions were influenced by person-centered care challenges, work community culture, workload, and leadership issues.
- Decisions balanced resident interests, workflow efficiency, and personal nurse interests.
- Nurses lacked support and established protocols for prioritization, leading to the concealment of unfinished care.
Conclusions:
- Nursing leadership must acknowledge and address the hidden phenomenon of prioritization decision-making and unfinished care.
- Involving nurses in protocol development and open discussion is recommended.
- Findings can inform strategies to support nurses, reduce workload, and enhance person-centered care quality in nursing homes.
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