AIM: To examine Croatian nurses' perception of implicit nursing care rationing and the patient safety culture from the perspective of acute care hospital staff. BACKGROUND: In the past three decades, the Croatian health system has undergone numerous transformations driven by geopolitical, legal, financial, demographic, scientific and technological progress. These changes have led to systemic changes in the structure, organisation, financing and delivery of health care, and thus, of nursing care. METHODS: A cross-sectional study of 438 nurses was conducted at four university hospitals in Croatia, based on the Perceived Implicit Rationing of Nursing Care Questionnaire. RESULTS: A lower assessment of the quality of care in the unit is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = -.379, p < .001. A lower satisfaction with the current workplace is associated with a higher score on the Perceived Implicit Rationing of Nursing Care Questionnaire, r = -.432, p < .001. CONCLUSION: The perception of nurses in Croatia indicates that the implications of nursing care rationing and dissatisfaction with their post in acute care hospital units are closely related to poor quality of nursing care provided to patients. IMPLICATIONS FOR NURSING MANAGEMENT: Based on these results, nurse managers should take their nurses' perceptions of implicit nursing care rationing into consideration in order to develop strategies to improve nursing care delivery, nursing satisfaction and, consequently, better nursing care quality.

Faculty of Medicine Department of Nursing and Midwifery University of Ostrava Ostrava Czech Republic

Teaching Institute of Public Health Andrija Stampar Zagreb Croatia

University Hospital Centre Rijeka Rijeka Croatia

University Hospital Centre Sestre milosrdnice Zagreb Croatia

University Hospital Centre Zagreb Zagreb Croatia

University Hospital Dubrava Zagreb Croatia

University Hospital Sveti Duh Zagreb Croatia

University of Applied Health Sciences Zagreb Croatia

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