Table 5

Interscale correlations for PIRNCA items

How often did it happen in the last 7 working days?		Alpha value with the question excluded	Item-total correlation
1	You could not carry out routine hygiene in patients (eg, bath, oral hygiene, dental care) or to ensure that the task was performed by delegating it to another health care worker?	0.957	0.527
2	You could not perform routine skin care to a patient or to ensure that the task was performed by delegating it to another health care worker?	0.956	0.553
3	You could not change the bedding stained with blood or body fluids in a timely manner or ensure that the task was performed by delegating it to another health care worker?	0.956	0.555
4	You could not assist a patient in need of walking or ensure that the task was performed by delegating it to another health care worker?	0.96	0.553
5	You could not mobilise a patient or change the position of a patient with limited mobility or ensure that the task was performed by delegating it to another health care worker	0.955	0.665
6	You could not provide quick assistance in emptying the bowel or bladder (eg, using a bedpan, toilet chair) or toilet or ensure that the task was performed by delegating it to another health care worker?	0.955	0.663
7	Could not provide help for a patient unable to eat or drink unassisted, regardless of the manner of food intake or ensure that the task was performed by delegating it to another health care worker?	0.955	0.654
8	You could not implement measures promoting physical comfort (eg, timely administration of painkillers, adjusting temperature, back or neck massage) or ensure that the task was performed by delegating it to another health care worker?	0.956	0.589
9	You could not administer drugs (including intravenous therapy) in accordance with the recommendations and principles of safe pharmacotherapy?	0.956	0.62
10	You could not administer enteral or parenteral nutrition as prescribed and in accordance with nursing safe practices?	0.955	0.597
11	You could not provide sufficient care of sores (including changing dressings) as prescribed by a doctor/according to the health unit standards or when you find it necessary?	0.956	0.65
12	You could not change the venous access site, the tube and/or dressings within prescribed time or according to the standards of the health unit or when you find it necessary?	0.956	0.673
13	You could not fully adhere to the guidelines for safe nursing practices (eg, use of assistive equipment and lifts and/or additional personnel)?	0.956	0.607
14	You could not fully adhere to the guidelines for infection control (eg, hand hygiene, aseptic technique, isolation)?	0.956	0.633
15	You could not offer enough time to educate a patient and family, which in your opinion was necessary?	0.956	0.599
16	You could not prepare patients properly for treatment, tests or other medical procedures?	0.956	0.616
17	You could not offer the level of emotional or psychological support to a patient (or family) that you felt was needed?	0.956	0.69
18	You could not monitor patient's physiological condition (eg, vital signs, laboratory values) according to doctor's prescription/ health unit standards or when you found it necessary?	0.956	0.601
19	You could not monitor the emotions and behavior of a patient (eg, medication compliance, eating habits, social contacts, and mood) according to doctor's prescription/ health unit standards or when you found it necessary?	0.955	0.701
20	You could not monitor the physical safety of a patient according to the doctor's prescriptions/health unit standards or when you considered it necessary?	0.955	0.674
21	You could not monitor changes in patient's condition, missed requests for intervention (including assessment or referral) or unclear requests?	0.955	0.657
22	You had to keep a patient or family member waiting for more than 5 minutes from the moment they signalled the request (eg, by alert light)?	0.956	0.535
23	You could not have an important conversation with another member of the multidisciplinary team regarding a particular patient care, or this conversation was postponed?	0.955	0.636
24	You could not have an important conversation with an external unit regarding a particular patient care, or this conversation was postponed	0.955	0.609
25	You could you not have an important conversation with a patient or a family member about the instructions related to the hospital discharge, or the conversation was postponed?	0.955	0.709
26	You could not monitor or track the completion of delegated activities?	0.956	0.73
27	You could not review the interdisciplinary records of a patient to obtain comprehensive patient data?	0.955	0.681
28	You could not document the initial or modified care plan?	0.955	0.69
29	you could not document all activities referring to monitoring and assessment of patient's condition?	0.955	0.666
30	You could not document the entire process of nursing care in detail?	0.955	0.646
31	You could not assess the nursing care plan properly (using critical thinking) to determine validity and / or effectiveness of the intervention and to introduce recommended changes?	0.956	0.678

PIRNCA, Perceived Implicit Rationing of Nursing Care.