Ethics of rationing of nursing care

2016 ◽  
Vol 25 (5) ◽  
pp. 591-600 ◽  
Author(s):  
Zahra Rooddehghan ◽  
Zohreh Parsa Yekta ◽  
Alireza N Nasrabadi
Keyword(s):  
Nursing Care ◽  
Nurse Managers ◽  
Qualitative Content Analysis ◽  
Care Patient ◽  
Negative Consequences ◽  
Face To Face ◽  
Clinical Nurses ◽  
Patient Dissatisfaction ◽  
Life Phenomena ◽  
Missed Nursing Care

Background: Rationing of various needed services, for example, nursing care, is inevitable due to unlimited needs and limited resources. Rationing of nursing care is considered an ethical issue since it requires judgment about potential conflicts between personal and professional values. Objectives: The present research sought to explore aspects of rationing nursing care in Iran. Research design: This study applied qualitative content analysis, a method to explore people’s perceptions of everyday life phenomena and interpret the subjective content of text data. Data collection was performed through in-depth, unstructured, face-to-face interviews with open-ended questions. Participants and research context: The study population included Iranian nurses of all nursing positions, from clinical nurses to nurse managers. Purposive sampling was employed to select 15 female and 3 male nurses (11 clinical nurses, 3 supervisors, 1 matron, 1 nurse, and 2 members of the Nursing Council) working in hospitals of three cities in Iran. Ethical considerations: The study protocol was approved by Tehran University of Medical Sciences (91D1302870). Written informed consent was also obtained from all participants. Findings: According to the participants, rationing of nursing care consisted of two categories, that is, causes of rationing and consequences of rationing. The first category comprised three subcategories, namely, patient needs and demands, routinism, and VIP patients. The three subcategories forming the second category were missed nursing care, patient dissatisfaction, and nurses’ feeling of guilt. Conclusion: Levels at which healthcare practices are rationed and clarity of the rationing are important structural considerations in the development of an equal, appropriate, and ethical healthcare system. Moreover, the procedure of rationing is critical as it not only influences people’s lives but also reflects the values that dominate in the society. Therefore, in order to minimize the negative consequences of rationing of nursing care, further studies on the ethical dimensions of this phenomenon are warranted.

scholarly journals Factors Affecting Nurses’ Perceived Organizational Commitment: A Qualitative Study

2019 ◽  
Vol 18 (2) ◽  
pp. 303-311 ◽  
Author(s):  
Faribah Sepahvand ◽  
Foorozan Atashzadeh Shoorideh ◽  
Soroor Parvizy ◽  
Mansoureh Zagheri Tafreshi
Keyword(s):  
Content Analysis ◽  
Organizational Commitment ◽  
Qualitative Study ◽  
Nurse Managers ◽  
Qualitative Content Analysis ◽  
Medical Science ◽  
Organizational Factors ◽  
Structured Interviews ◽  
Factors Affecting ◽  
Clinical Nurses

Objective: Nurses’ organizational commitment is one of the most important factors that facilitates their professional evolution and influences the method of care provision, quality of care, and patients’ satisfaction. The aim of this study was identified the factors that affect nurses’ perceived organizational commitment. Material and Methods: This qualitative study, conducted on 16 clinical nurses employed in Social Security Hospital of Khorramabad, Iran, during five months from May to September 2015, used deep semi-structured interviews. Purposive sampling method was used for the selection of nurses and the data were analyzed using conventional qualitative content analysis. Lincoln & Guba’s criteria were used to secure data accuracy and stability. Results: Sixteen subcategories, five categories, and three themes were distilled during content analysis process. The abstracted themes included “organizational factors”, “occupational challenges”, and “contributory management”. Conclusion: Our findings showed that numerous factors present in nurses’ profession and work environment may influence the rate of nurses’ interest and commitment in the hospital and the related organization. Hence, nurse managers can foster the promotion of nurses’ organizational commitment through creating the required suitable conditions. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.303-311

scholarly journals Explaining Courage in Ethical Decision-making by Nursing Managers: A Qualitative Content Analysis

2021 ◽  
Vol 31 (4) ◽  
pp. 254-262
Author(s):  
Mostafa Roshanzadeh ◽  
◽  
Zohreh Vanaki ◽  
Afsaneh Sadooghiasl ◽  
Ali Tajabadi ◽  
...  
Keyword(s):  
Decision Making ◽  
Content Analysis ◽  
Ethical Decision ◽  
Nurse Managers ◽  
Ethical Decision Making ◽  
Ethical Issues ◽  
Qualitative Content Analysis ◽  
Role Playing ◽  
Face To Face ◽  
Nursing Managers

Introduction: Ethical decision-making by nursing managers is influenced by various essential factors, such as courage, without which it is impossible to act on them. Objective: This study aimed to explore the experiences of nursing managers about courage in ethical decision-making. Materials and Methods: The current study was conducted in Iran by a qualitative content analysis approach in 2018. Nineteen nurse managers were selected purposefully from hospitals in Tehran and Shahrekord cities. Data were collected using semi-structured, in-depth, face-to-face interviews, and after transcription, they were analyzed according to the Graneheim and Lundman method. Results: Based on data analysis, we extracted 2 categories (obligation, decisiveness) and 8 subcategories (clearness in expressing decisions, the ability of the manager to make decisions in critical and complex situations, authority/decision-making as a religious responsibility, follow the decision process, being responsible, making compensatory decisions, making preventive decisions). Conclusion: The findings showed that managers who are committed to ethical decision-making have enough assertiveness to make the decisions. Educating, empowering, and sensitizing managers and enhancing their insight into ethical issues through problem-solving and role-playing techniques can play an essential role in promoting their commitment and responsibility.

Missed nursing care and complexity theory: a conceptual paper

2021 ◽  
pp. 174498712110130
Author(s):  
Rania Ali Albsoul ◽  
Gerard FitzGerald ◽  
James A Hughes ◽  
Muhammad Ahmed Alshyyab
Keyword(s):  
Complexity Theory ◽  
Nursing Care ◽  
Complex Adaptive Systems ◽  
Adaptive Systems ◽  
Nurse Managers ◽  
Systems Approach ◽  
Complex Adaptive ◽  
Missed Care ◽  
Missed Nursing Care ◽  
The Impact

Background Missed nursing care is a complex healthcare problem. Extant literature in this area identifies several interventions that can be used in acute hospital settings to minimise the impact of missed nursing care. However, controversy still exists as to the effectiveness of these interventions on reducing the occurrence of missed nursing care. Aim This theoretical paper aimed to provide a conceptual understanding of missed nursing care using complexity theory. Methods The method utilised for this paper is based on a literature review on missed care and complexity theory in healthcare. Results We found that the key virtues of complexity theory relevant to the missed nursing care phenomenon were adaptation and self-organisation, non-linear interactions and history. It is suggested that the complex adaptive systems approach may be more useful for nurse managers to inform and prepare nurses to meet uncertain encounters in their everyday clinical practice and therefore reduce instances of missed care. Conclusions This paper envisions that it is time that methods used to explore missed care changed. Strategies proposed in this paper may have an important impact on the ability of nursing staff to provide quality and innovative healthcare in the modern healthcare system.

scholarly journals Nurses' efforts to maintain competence: a qualitative study

2021 ◽  
Author(s):  
Nur Miladiyah Rahmah ◽  
Tutik Sri Hariyati ◽  
Junaiti Sahar
Keyword(s):  
Nursing Care ◽  
Clinical Competence ◽  
Nurse Managers ◽  
Continuing Professional Development ◽  
Nursing Services ◽  
Ensure Patient Safety ◽  
Missed Care ◽  
Qualitative Phenomenological ◽  
Missed Nursing Care ◽  
Competence System

Background: The clinical competence of nurses should be maintained to ensure patient safety. Competence is the integration of knowledge, skills, and attitudes. Nurse competency also improves the quality of nursing care and reduces the incidence of missed nursing care. This study aimed to explore the experiences of nurses maintaining a nurse competence system in hospitals through continuing education.Design and Methods: The research method used was qualitative phenomenological research, and the data was collected through an in-depth interview which was consist of six participants.Results: The results of the research were 1). continuing professional development to maintain the competence, 2) credentialing system in the career ladder system, 3). missed care still occurred in the implementation of nursing services 4). Nurses had hopes that managers supported the efforts to maintain competence through continuing professional development.Conclusion: Nurse managers are expected to improve the supervision program to maintain clinical competence and decrease missed care.

Experiences of Iranian Pediatric Nurses in Providing Care to Hospitalized Children of Different Language Backgrounds: A Qualitative Study

2021 ◽  
pp. 104365962110165
Author(s):  
Raziyeh Beykmirza ◽  
Reza Negarandeh ◽  
Maryam Varzeshnejad
Keyword(s):  
Content Analysis ◽  
Nursing Care ◽  
Qualitative Content Analysis ◽  
Main Theme ◽  
Hospitalized Children ◽  
Pediatric Nurses ◽  
Language Differences ◽  
Face To Face ◽  
Pediatric Hospitals ◽  
Conventional Content Analysis

Introduction Communication is one of the main foundations of providing care. Nurses have encountered patients from different languages due to globalization and mobilities within and between countries. This study aimed to explore the Iranian pediatric nurses’ experiences in providing care for children of different language backgrounds. Methodology In this conventional qualitative content analysis study, 15 pediatric nurses were selected through purposive sampling from four specialty pediatric hospitals in Tehran, Iran. Data were collected via in-depth semistructured face-to-face interviews and concurrently analyzed via conventional content analysis. Results Data analysis resulted in 132 primary codes, which were reduced to 95 during constant comparison and categorized into 34 subcategories, six main categories, and the main theme emerging from the categories was “language as a barrier in providing effective nursing care.” Discussion This study suggests that language differences between pediatric nurses and hospitalized children may make nursing care less effective and act as a barrier to achieving patient care goals.

scholarly journals Perspectives of Oncology Unit Nurse Managers on Missed Nursing Care: A Qualitative Study

2018 ◽  
Vol 5 (3) ◽  
pp. 327 ◽  
Author(s):  
Fatemeh Ghaffari ◽  
Nahid Dehghan-Nayeri ◽  
Mahboobeh Shali ◽  
Nasrin Navabi
Keyword(s):  
Qualitative Study ◽  
Nursing Care ◽  
Nurse Managers ◽  
Oncology Unit ◽  
Missed Nursing Care

scholarly journals A qualitative exploration of patients’ experiences, needs and expectations regarding online access to their primary care record

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044221
Author(s):  
Brian McMillan ◽  
Gail Davidge ◽  
Lindsey Brown ◽  
Moira Lyons ◽  
Helen Atherton ◽  
...  
Keyword(s):  
Primary Care ◽  
Focus Groups ◽  
Negative Consequences ◽  
Face To Face ◽  
Primary Care Record ◽  
Online Access ◽  
Additional Support ◽  
The Uk ◽  
Records Access ◽  
Qualitative Exploration

ObjectivesPrimary care records have traditionally served the needs and demands of clinicians rather than those of the patient. In England, general practices must promote and offer registered patients online access to their primary care record, and research has shown benefits to both patients and clinicians of doing so. Despite this, we know little about patients’ needs and expectations regarding online access to their record. This study explored what patients and carers want from online access to their electronic primary care health record, their experiences of using it, how they would like to interact with their record and what support they may need.DesignFocus groups and semistructured interviews using purposive sampling to achieve a good sociodemographic spread. Interviews were digitally audiorecorded, transcribed and coded using an established thematic approach.SettingFocus groups and interviews were conducted in community settings in the UK.ParticipantsFifty-four individuals who were either eligible for the National Health Service Health Check, living with more than one long-term condition or caring for someone else.ResultsParticipants views regarding online access were categorised into four main themes: awareness, capabilities, consequences and inevitability. Participants felt online access should be better promoted, and suggested a number of additional functions, such as better integration with other parts of the healthcare system. It was felt that online access could improve quality of care (eg, through increased transparency) but also have potential negative consequences (eg, by replacing face to face contact). A move towards more online records access was considered inevitable, but participants noted a need for additional support and training in using the online record, especially to ensure that health inequalities are not exacerbated.ConclusionsDiscussions with patients and carers about their views of accessing online records have provided useful insights into future directions and potential improvements for this service.

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