Rationing nursing care and nurses’ work environment as a factor influencing the occurrence and level of rationing care – a scoping review

Abstract Aim. The aim is to describe and analyse the available studies describing the assigned nursing care and work environment of nurses. Design: Scoping review. Methods. The search was conducted in four scientific databases Ovid Nursing, ProQuest, PubMed, and Scopus. Eleven studies published between years 2000 and 2020 were included in the review. Results. Eleven cross-sectional and correlational studies were analysed to document the prevalence of rationed nursing care in the acute hospital care setting. Studies evaluating rationed nursing care confirm a strong relationship with the workplace nursing environment. Thus, the work environment is among the significant determinants of rationed nursing care. The most commonly used tools include the PIRNCA tool for assessing hidden rationing of care and the PES-NWI tool for monitoring the work environment of nurses. When the work environment is rated as unfavourable, there is a higher rate of rationed nursing care. Conclusions. Rationed nursing care is a phenomenon that is monitored globally, and its assessment is essential in health care delivery. The main reasons for the development of hidden rationing of care include inadequate staffing and facilities. Factors that contribute significantly to the rationed nursing care are based on the work environment - mainly interpersonal relationships and communication, multidisciplinary collaboration.