The Potential Impact of Nursing Workload and Work Environment on Nurses Leading them to Ration or Miss Care in ICU Settings: A Systematic Review.

Abstract

Title: The Potential Impact of Nursing Workload and Work Environment on Nurses Leading them to Ration or Miss Care in ICU Settings: A Systematic Review. Background: Intensive Care Units (ICUs) provide life-saving care to critically sick patients resulting in numerous challenges for nurses (Moradi et al., 2021). Heavy workloads, time limits, and resource shortages all contribute to a problem known as "rationing of nursing care," in which essential tasks are left undone because of limitations. Addressing nurse needs and building supportive work cultures are critical elements in maintaining quality care for everyone in ICUs. Aim: Objectives: To examine how the nurses’ workload and work environment could potentially impact nurses to ration and miss care in ICU settings. 1. To identify what aspects of ICU care could be affected by the rationing of nursing care. 2. To investigate if ICU workload and work environment lead nurses to care rationing. 3. Exploring what measures could be implemented to limit the rationing of nursing care in ICU settings. Methodology: A systematic review, started with comprehensive electronic search of databases, and a meticulously crafted search strategy was done to identify a relevant latest published articles. Full texts were subsequently screened for eligible studies, ultimately leading to the inclusion of thirteen studies, nine were quantitative studies, one qualitative study, and three mixed-methods studies. Conclusion: Thirteen research that were evaluated for validity and relevance shed light on the factors that lead to care rationing. High workload, patient-to-nurse ratios, a poor work environment, resource limitations, and job satisfaction emerge as major factors. Notably, while the quality of the research varies, they all demonstrate significant rationed care, with activities such as ambulation and patient comfort falling victim. Interestingly, no reported missed care was identified in a patient-focused investigation, implying a potential gap between nurses' and patients' perspectives.