Impacts of Rationing and Missed Nursing Care: Challenges and Solutions

This book reveals how economic restrictions and limited healthcare resources, combined with growing care demands due to advanced technology and more care options, have to a great extent contributed to increased workloads for healthcare professionals and put them under pressure to prioritize their work. This has led to the rationing of care, i.e., to decision-making processes on the allocation of scarce resources, especially human resources, and on which care activities take priority over others; in turn, these processes have led to unfinished or missed care, which has serious implications for quality of care and patient safety. Concerns related to nursing shortages and lean staffing practices have increased the awareness of the problem, as patient outcomes are affected by the quality and quantity of care that they receive and led to intensified scientific inquiry into this phenomenon. This book is written by the members of the Rancare Cost Action group, whose aim is to facilitate discussion about rationing of nursing care based on a cross-national comparative approach with implications for practice and professional development. Four working groups investigated four areas for four years: a) the conceptualization of care rationing and methodological inquiries concerning the investigation of the phenomenon, b) exploration of possible solutions and intervention studies, c) the ethical perspective of care rationing and missed care including patients’ rights and possible discrimination, and d) the educational implications, based on an exploration of the level of patient safety training and care rationing, as well as preparing guidelines for managers. The book will be a valuable resource for nurses, allied healthcare professionals, managers, policymakers, researchers, ethical committees, and educators whose goal is to provide better and safer care.