Clarifying the concept of implicit rationing of nursing care: concept analysis using Walker and Avant’s approach

Implicit rationing of nursing care is a growing concern in health care systems and can cause adverse consequences for patients. Considering the importance of the issue in the health system, it is necessary to clarify the different dimensions of this concept. Therefore, this study was conducted to clarify the concept of implicit rationing of nursing care using Walker and Avant's approach.

Walker and Avant’s approach was used to analyze the concept of implicit rationing of care. The search was conducted in the Web of Science, PubMed, and Scopus, SID, Iran Medex, Magiran databases using the keywords of implicit rationing, nursing care, implicit rationing of nursing care, and rationing of nursing care without a time limit until October 2023. Finally, according to entry and exit criteria, 13 relevant articles were analyzed.

The review of the literature showed that the concept of implicit rationing of nursing care is a complex concept with numerous dimensions. The antecedents of this concept are related to patients, nurses, and the organization. Decision-making, prioritization, outcome assessment, obligation to perform nursing care, and disruptions in the process of performing nursing interventions were identified as the determining features of the concept of implicit rationing of nursing care.

The present study showed that implicit rationing of nursing care was a multifaceted concept. Nursing managers and researchers can use the results of this study to design effective measures and interventions to reduce its incidence.