A Descriptive Analysis of Implicit Rationing of Nursing Care: Frequency and Patterns in Texas.

The frequency and patterns of implicit rationing of nursing care in the United States are not known. The purpose of this study was to examine the phenomenon of implicit rationing among nurses in Texas. Implicit rationing was measured using a 31-item survey instrument adapted from the parent instrument originating in Switzerland. Some degree of rationing on at least one of the nursing care activities was reported by almost all of the respondents and most rationed multiple activities. Rationing preference patterns favor completion of activities directed to meet immediate physiological needs over other activities. If the relationships documented in other countries between implicit rationing and adverse patient outcomes are also present in the United States, then implicit rationing may serve as an important quality indicator.