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Rationing of Nursing Care and Its Relationship with Nurse Staffing and Patient Outcomes: The Mediation Effect Tested by Structural Equation Modeling

Author

Listed:
  • Xiaowen Zhu

    (School of Nursing, Jinan University, Guangzhou 510632, China
    Xiaowen Zhu and Jing Zheng should be considered joint first author.)

  • Jing Zheng

    (School of Nursing, Guangdong Pharmaceutical University, Guangzhou 510310, China
    Xiaowen Zhu and Jing Zheng should be considered joint first author.)

  • Ke Liu

    (School of Nursing, Sun Yat-sen University, Guangzhou 510080, China)

  • Liming You

    (School of Nursing, Sun Yat-sen University, Guangzhou 510080, China)

Abstract

Purpose : The purpose of this study is to test the mediation effect of rationing of nursing care (RONC) and the relationship this has between nurse staffing and patient outcomes. Methods : The analytic sample included 7802 nurse surveys and 5430 patient surveys. Three patient outcome indicators, nurse staffing, RONC, and confounding factors were considered in the model pathways. Results : The hypothesized model was shown to be statistically significant. In the model, nurses who were in the units with lower nurse-to-patient ratios reported higher scores on RONC, which meant that an increased level of withheld nursing care or a failure to carry out nursing duties was apparent. Nurses who reported a higher score on RONC, scored poorly on the quality assessment and were more frequently involved in patient adverse events. Nurse staffing influenced quality assessments and patient adverse events through RONC. In units with poorer nurse-reported quality assessments or more frequently patient adverse events, patient-reported dissatisfaction scores were higher. Conclusions : The results suggest that a lack of nurse staffing leads to RONC, which leads to poorer patient outcomes. These results are seen when considering the evaluations completed by both nurses and patients. The relationship between staffing numbers and patient outcomes explains the mediating role of RONC.

Suggested Citation

  • Xiaowen Zhu & Jing Zheng & Ke Liu & Liming You, 2019. "Rationing of Nursing Care and Its Relationship with Nurse Staffing and Patient Outcomes: The Mediation Effect Tested by Structural Equation Modeling," IJERPH, MDPI, vol. 16(10), pages 1-11, May.
  • Handle: RePEc:gam:jijerp:v:16:y:2019:i:10:p:1672-:d:230820
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    Citations

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    Cited by:

    1. Agnieszka Młynarska & Anna Krawuczka & Ewelina Kolarczyk & Izabella Uchmanowicz, 2020. "Rationing of Nursing Care in Intensive Care Units," IJERPH, MDPI, vol. 17(19), pages 1-13, September.
    2. Sara Anunciada & Patrícia Benito & Filomena Gaspar & Pedro Lucas, 2022. "Validation of Psychometric Properties of the Nursing Work Index—Revised Scale in Portugal," IJERPH, MDPI, vol. 19(9), pages 1-10, April.

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