Abstract：
BACKGROUND: Prioritization decision-making arises when nurses encounter intricate situations that demand ethically challenging judgments about care. This phenomenon has rarely been studied in nursing homes. Prioritization decision-making may lead to instances where individuals in social and healthcare may not receive all services they need. Making prioritization decisions and awareness of their consequences can increase nurses\' workload.
OBJECTIVE: To describe prioritization decision-making regarding unfinished nursing care in nursing homes.
METHODS: A qualitative descriptive study conducted through individual theme interviews. Participants were recruited through social media. The data was analyzed using inductive content analysis.
METHODS: Nurses (n = 23) working in nursing homes for the elderly people in Finland. Data were collected between June 2022 and February 2023.
METHODS: Finnish legislation does not mandate an ethical review or research permits, as the participants took part as private individuals. [ask authors to make reference here to informed consent process and anonymity].
RESULTS: Nurses stated that the need for prioritization decision-making arises from challenges associated with nurses\' engagement with person-centered care, the culture of the work community, the burden due to workload and challenges associated with the leadership. Prioritization decision-making was based on the interests of residents, striving for an efficient workflow and nurse\'s personal interests. Nurses did not receive support for decision-making regarding unfinished care, and protocols for prioritization had not been established in their work communities. Prioritization decision-making and unfinished care were concealed and left unspoken.
CONCLUSIONS: Nursing leaders should address this hidden phenomenon, making it visible through discussions with nurses and by involving them in the development of protocols. The findings can be utilized for developing new approaches to support nurses and reduce their workload and for enhancing the quality and person-centeredness of nursing care in nursing homes.
OBJECTIVE: To describe prioritization decision-making regarding unfinished nursing care in nursing homes.
METHODS: A qualitative descriptive study conducted through individual theme interviews. Participants were recruited through social media. The data was analyzed using inductive content analysis.
METHODS: Nurses (n = 23) working in nursing homes for the elderly people in Finland. Data were collected between June 2022 and February 2023.
METHODS: Finnish legislation does not mandate an ethical review or research permits, as the participants took part as private individuals. [ask authors to make reference here to informed consent process and anonymity].
RESULTS: Nurses stated that the need for prioritization decision-making arises from challenges associated with nurses\' engagement with person-centered care, the culture of the work community, the burden due to workload and challenges associated with the leadership. Prioritization decision-making was based on the interests of residents, striving for an efficient workflow and nurse\'s personal interests. Nurses did not receive support for decision-making regarding unfinished care, and protocols for prioritization had not been established in their work communities. Prioritization decision-making and unfinished care were concealed and left unspoken.
CONCLUSIONS: Nursing leaders should address this hidden phenomenon, making it visible through discussions with nurses and by involving them in the development of protocols. The findings can be utilized for developing new approaches to support nurses and reduce their workload and for enhancing the quality and person-centeredness of nursing care in nursing homes.
摘要：
背景：当护士遇到复杂的情况需要道德上具有挑战性的护理判断时，就会出现优先决策。这种现象很少在养老院进行研究。优先决策可能导致社会和医疗保健领域的个人可能无法获得所需的所有服务。做出优先决定和对其后果的认识可以增加护士的工作量。
目的：描述养老院未完成护理的优先决策。
方法：通过个别主题访谈进行的定性描述性研究。参与者是通过社交媒体招募的。使用归纳内容分析对数据进行分析。
方法：在芬兰老年人疗养院工作的护士（n=23）。数据收集于2022年6月至2023年2月之间。
方法：芬兰立法不强制要求伦理审查或研究许可，参与者以私人身份参加。[请作者在此提及知情同意程序和匿名]。
结果：护士指出，优先决策的需要来自与护士参与以人为本的护理相关的挑战，工作社区的文化，与领导相关的工作量和挑战带来的负担。优先决策以居民利益为基础,追求高效的工作流程和护士的个人利益。护士没有得到有关未完成护理的决策的支持，在其工作社区中尚未制定优先次序的协议。优先决策和未完成的护理被隐藏起来，没有说出来。
结论：护理领导者应该解决这种隐藏的现象，通过与护士的讨论以及让他们参与协议的制定，使其可见。这些发现可用于开发新的方法来支持护士并减少他们的工作量，并提高养老院护理的质量和以人为本。
目的：描述养老院未完成护理的优先决策。
方法：通过个别主题访谈进行的定性描述性研究。参与者是通过社交媒体招募的。使用归纳内容分析对数据进行分析。
方法：在芬兰老年人疗养院工作的护士（n=23）。数据收集于2022年6月至2023年2月之间。
方法：芬兰立法不强制要求伦理审查或研究许可，参与者以私人身份参加。[请作者在此提及知情同意程序和匿名]。
结果：护士指出，优先决策的需要来自与护士参与以人为本的护理相关的挑战，工作社区的文化，与领导相关的工作量和挑战带来的负担。优先决策以居民利益为基础,追求高效的工作流程和护士的个人利益。护士没有得到有关未完成护理的决策的支持，在其工作社区中尚未制定优先次序的协议。优先决策和未完成的护理被隐藏起来，没有说出来。
结论：护理领导者应该解决这种隐藏的现象，通过与护士的讨论以及让他们参与协议的制定，使其可见。这些发现可用于开发新的方法来支持护士并减少他们的工作量，并提高养老院护理的质量和以人为本。
