Surgical Nurses' Perspectives on Low‐Value Care and Non‐Nursing Tasks: A Cross‐Sectional Study

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BACKGROUND: Low-value care provides little or no benefit to patients, or its risk of harm outweighs the potential benefits. Non-nursing tasks refer to tasks performed by nurses below their scope of practice. With increasing pressure on the global nursing workforce, it is necessary to identify these concepts to deliver fundamental care. AIM(S): To assess the prevalence, influencing factors and associations of low-value nursing care, and to identify non-nursing tasks and potential solutions in surgical hospital care settings. DESIGN: The study followed a cross-sectional study design using a self-developed questionnaire. METHODS: A questionnaire on low-value care and non-nursing tasks was distributed to surgical wards in four hospitals in The Netherlands. RESULTS: A total of 302 nurses responded to the survey. Five most prevalent low-value care practices were identified, including routine preoperative fasting (84.8%), taking over blood glucose monitoring (59.3%) and leaving in place any type of venous catheter (42.1%). These practices were mainly performed due to habitual practice, in accordance with an established protocol, or upon physicians' request. Most reported non-nursing tasks were administrative duties and cleaning patient rooms and equipment. Provided solutions included clearly defining responsibilities and taking personal responsibility. CONCLUSION: Low-value care, provided by surgical nurses, is common in daily practice. This requires targeted de-implementation of each low-value care practice, based on influencing factors. Additionally, 85.8% of nurses perform non-nursing tasks daily or several times a day, underlining the need to re-organise nursing tasks. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: De-implementing low-value care and reducing non-nursing tasks is necessary to ease pressure on the global nursing workforce and to improve fundamental care. IMPACT: Low-value nursing care and non-nursing tasks persist when nurses lack leadership responsibility. REPORTING METHOD: STROBE checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient contribution.

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