The role of teamwork in the implicit rationing of nursing care: A systematic mixed-methods review

Aim: To systematically evaluate the role of teamwork in implicit rationing care and how to improve teamwork.

Background: The implicit rationing of nursing leads to adverse effects for both patients and nurses. Therefore, how to reduce it has attracted increasing research attention. How teamwork may be an important factor in reducing implicit rationing care has become a focus of research.

Methods: Data between May 2000 and May 2020 were collected from five databases. The study was guided by the framework of a mixed studies review.

Results: Seventeen studies were chosen for review regarding efficient teamwork to reduce implicit rationing care. The following seven subthemes with positive effects that improve teamwork and reduce implicit rationing care were formed: (a) improving knowledge and skills; (b) promoting effective communication; (c) building mutual trust; (d) reducing turnover intention; (e) reasonable staffing; (f) division of responsibilities; and (g) cultivating team consciousness.

Conclusions: Teamwork can decrease implicit care and is influenced by many factors, but the intervention is singular. In the future, teamwork can be further improved to reduce implicit care.

Implications for nursing management: With more intervention research in the future, leadership and team-oriented roles can be used to complete all the care needed.