TY - JOUR
T1 - Systems, economics, and neoliberal politics
T2 - Theories to understand missed nursing care
AU - Jones, Terry
AU - Drach-Zahavy, Anat
AU - Amorim-Lopes, Mário
AU - Willis, Eileen
PY - 2020/9/1
Y1 - 2020/9/1
N2 - The phenomenon of missed nursing care is endemic across all sectors. Nurse leaders have drawn attention to the implications of missed care for patient outcomes, with calls to develop clear political, methodological, and theoretical approaches. As part of this call, we describe three structural theories that inform frameworks of missed care: systems theory, economic theory, and neoliberal politics. The final section provides commentary on the strengths and limitations of these three theories, in the light of structuration theory and calls to balance this research agenda by reinstating nurse agency and examining the interactions between nurses as agents and the health systems as structures. The paper argues that a better understanding of variations in structure–agency interaction across the healthcare system might lead to more effective interventions at strategic leverage points.
AB - The phenomenon of missed nursing care is endemic across all sectors. Nurse leaders have drawn attention to the implications of missed care for patient outcomes, with calls to develop clear political, methodological, and theoretical approaches. As part of this call, we describe three structural theories that inform frameworks of missed care: systems theory, economic theory, and neoliberal politics. The final section provides commentary on the strengths and limitations of these three theories, in the light of structuration theory and calls to balance this research agenda by reinstating nurse agency and examining the interactions between nurses as agents and the health systems as structures. The paper argues that a better understanding of variations in structure–agency interaction across the healthcare system might lead to more effective interventions at strategic leverage points.
KW - economic
KW - missed care, political economy
KW - structuration theory, nursing
KW - systems
KW - neoliberal politics
UR - http://www.scopus.com/inward/record.url?scp=85082198523&partnerID=8YFLogxK
U2 - 10.1111/nhs.12700
DO - 10.1111/nhs.12700
M3 - Article
AN - SCOPUS:85082198523
VL - 22
SP - 586
EP - 592
JO - Nursing & Health Sciences
JF - Nursing & Health Sciences
SN - 1442-2018
IS - 3
ER -