Interventions to Reduce and Limit Rationed and Missed Nursing Care: State of the Art and Future Perspectives

While our knowledge on the occurrence of rationed and missed nursing care and its associations with patient and nurse outcomes has increased, we still know very little on how we can effectively reduce and limit the level of rationed and missed nursing care. There are several interventions reported in the literature (e.g., staff planning and teamwork development) that have the potential to reduce and limit rationed and missed nursing care, as well as positively influence the performance of selected nursing care activities. Yet, the number of studies and the level of evidence is low. There are currently no studies dealing with interventions focused on safety climate, ethical climate, or nurse education and experience, all of which might offer a potential benefit as they have shown to predict rationed and missed nursing care. Moreover, there is a lack of studies on the use of technology (e.g., telehealth, robotics) to support nurses, e.g., in the process of decision-making and priority setting. Implementation science could provide guidance on the development, implementation, and evaluation of effective interventions to reduce and limit rationed and missed nursing care and help tackle some of the methodological challenges to generate the needed evidence to understand, when, why, and how such interventions work. The aim of this chapter is to provide a synthesis of the literature and give some future perspectives on interventions that may reduce or limit rationed and missed nursing care.