What enables and hinders nursing staff in delivering person-centred fundamental care? A qualitative study within the incharge programme

哪些因素能够促进和阻碍护理人员提供以人为本的基本护理?一项在主管培训计划中进行的定性研究

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Abstract

BACKGROUND: Meeting patients' fundamental care needs is a core aspect of nursing. However, there is compelling evidence of missed nursing care within surgical care. Person-centred care is known to increase patient involvement and prevent missed nursing care. The Fundamentals of Care framework aligns with person-centred care principles. It has the essential relationship-based care process at its core and serves as a guide for delivering person-centred fundamental care. This study aims to describe what enables and hinders the delivery of person-centred fundamental care as identified by registered nurses and nursing assistants in a surgical department. METHODS: A qualitative descriptive study was performed. Registered nurses and nurse assistants (nursing staff) from three surgical wards at a university hospital participated in a workshop package about person-centred fundamental care. Data were collected from two workshops with 106 and 92 participants, respectively, individual written reflections on a situation in clinical practice related to person-centred fundamental care delivery (83 participants), and three focus group interviews with a total of 13 participants. The data were analysed using content analysis. RESULTS: The results present the nursing staffs' descriptions of what enables and hinders the delivery of person-centred fundamental care in three categories: [1] a culture of daily mentorship to ensure adherence to person-centred routines; [2] a distinct nursing leadership-supportive in both routines of daily practice and high-pressure situations; and [3] enhancing comprehension of person-centred care routines to embed the approach in everyday thinking and actions. CONCLUSIONS: To provide person-centred fundamental care, nursing staff need organizational support in both culture and routines. Nurse managers need to be clear on how care is to be delivered, challenge prevailing old habits, and act as role models in changing practices. Nursing staff need to take their responsibility by adhering to routines and contributing to driving changes. The results can be used to navigate the complex implementation of person-centred fundamental care and also demonstrate the need for a change toward person-centred fundamental care being valued and prioritized in organizations. CLINICAL TRIAL NUMBER: Not applicable.

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