CROATIAN ADAPTATION AND VALIDATION OF THE PERCEIVED IMPLICIT RATIONING OF NURSING CARE (PIRNCA) QUESTIONNAIRE: A CROSS-SECTIONAL STUDY.

The aim was to perform adaptation and validation of the Perceived Implicit Rationing of Nursing Care. Implicit delaying of nursing care is an intermediate step, linking nurses with the quality of outcomes for patients and nurses, and it is the result of prioritization of health care measures within the assigned group of patients cared for by nurses. The Perceived Implicit Rationing of Nursing Care instrument is a tool used to assess the rationing of care in nursing practice. Study participants were nurses working at hospital wards in 4 university hospitals in the Republic of Croatia. The questionnaire was filled-in by 438 nurses. Data were collected between April and November 2018. After principal axis factoring, a single factor solution based on the correlation matrix was adopted. The measured construct is one-dimensional, and the extracted factor explains 47.2% of its variance. Additionally, the reliability of the whole questionnaire was determined by using the internal consistency coefficient Cronbach alpha on the Perceived Implicit Rationing of Nursing Care with 31 of 0.96 particles, which is extremely high internal consistency reliability. In conclusion, the study found a high level of reliability and validity of the translated Perceived Implicit Rationing of Nursing Care questionnaire, fully comparable to that of the original. The questionnaire can be used to assess the phenomenon of implicit care rationing in Croatian hospitals.

Nurses' perception of implicit nursing care rationing in Croatia-A cross-sectional multicentre study.

AIM: To examine Croatian nurses' perception of implicit nursing care rationing and the patient safety culture from the perspective of acute care hospital staff. BACKGROUND: In the past three decades, the Croatian health system has undergone numerous transformations driven by geopolitical, legal, financial, demographic, scientific and technological progress. These changes have led to systemic changes in the structure, organisation, financing and delivery of health care, and thus, of nursing care. METHODS: A cross-sectional study of 438 nurses was conducted at four university hospitals in Croatia, based on the Perceived Implicit Rationing of Nursing Care Questionnaire. RESULTS: A lower assessment of the quality of care in the unit is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = -.379, p < .001. A lower satisfaction with the current workplace is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = -.432, p < .001. CONCLUSION: The perception of nurses in Croatia indicates that the implications of nursing care rationing and dissatisfaction with their post in acute care hospital units are closely related to poor quality of nursing care provided to patients. IMPLICATIONS FOR NURSING MANAGEMENT: Based on these results, nurse managers should take their nurses' perceptions of implicit nursing care rationing into consideration in order to develop strategies to improve nursing care delivery, nursing satisfaction and, consequently, better nursing care quality.