| 1. |
- Avallin, Therese, 1982-
(författare)
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Achieving person-centred pain management for the patient with acute abdominal pain : Guided by the Fundamentals of Care framework
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis is to explore how to achieve and measure person-centred pain management (PCPM) for the patient with acute abdominal pain (AAP) in acute surgical care. The Fundamentals of Care (FoC) framework guides all studies.The methods: In Study I, focused ethnography is used with 92h of participant observations (n=34) at the emergency department (n=1) and surgical wards (n=2), including 261 patient–provider interactions. In Study II, case study is used for secondary analysis of 20 observations from Study I. In Study III, a questionnaire is developed in a systematic process to measure PCPM, performed by combining; a validated questionnaire, theoretical and empirical evidence. The questionnaire is tested by question appraisal, theoretical experts (n=2), patients (n=5) and providers (n=5), and thereafter by patients (n=100) at surgical wards (n=4). In Study IV, a qualitative systematic review is performed with a synthesis by thematic analysis, to test and refine a model for PCPM from Study I. The synthesis includes 15 qualitative studies representing patients (n=495) and/or nurses (n=259) from n= 3 emergency departments and n=17 hospital wards in n=9 countries. The patients are ≥ 18 years old, with AAP (Studies I-IV), or acute pain from surgery (Study IV). The results confirms that the patient still suffer from unmanaged pain in acute surgical care, and presents actions on behalf of the patient and provider, and contextual factors including the organizational culture, to achieve and measure PCPM. The studies presents a model for PCPM from the patient perspective (Study I), patient-provider communications contributing to meeting fundamental care needs (Study II), an initially feasible and valid questionnaire to measure PCPM (Study III), and a tested and refined model for PCPM from the patient and nurse perspective (Study IV). Conclusion: This thesis presents scientific evidence providing an in-depth understanding of what is important for successful pain management from the patient’s and nurses’ perspectives, how these parts are interconnected, and how they can be achieved and measured. The results also show the feasible role of communication in meeting the patient’s fundamental care needs. This evidence is suggested to be tested and evaluated in clinical practice to perform PCPM, relieving the patient from pain.
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| 2. |
- Avallin, Therese, et al.
(författare)
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Measuring person-centred pain management : Development of a questionnaire using the Fundamentals of Care framework
- 2023
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 79:10, s. 3923-3934
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To develop and test a questionnaire using the Fundamentals of Care framework to measure person-centred pain management.Design: Cross-sectional exploratory descriptive design.Methods: Development in three phases: (a) literature search for questionnaires measuring person-centred pain management, (b) seven-step process developing items using thematic analysis, (c) initial feasibility and validity testing. Theoretical and empirical evidence was used, including the 'Strategic and Clinical Quality Indicators in Postoperative Pain management' questionnaire, the Fundamentals of Care framework and person-centredness principles. Theoretical experts (n = 2) reviewed the questionnaire, further evaluated by providers (n = 5) and patients (n = 5) using a think-aloud process, and by additional questions in the questionnaire answered by n = 100 patients. The questionnaire was tested February to March 2021, at four surgical wards in a university hospital.Results: The evaluation showed initial support for feasibility and validity, and the questionnaire was found to represent and be sensitive to capture the patients' experiences of person-centred pain management and being easy to answer. The 100 patients with acute abdominal pain who answered the questionnaire (aged 18-89 years, 46 women and 54 men), identified missing elements of fundamental care in their pain management, indicating that the questionnaire is sensitive to capture specific areas for improvement.Conclusion: This first attempt at transforming the essential components of person-centred pain management into measurable items in a questionnaire was found promising. The questionnaire is suggested to be further tested for psychometric properties and patient benefit to provide clinical guidance in acute surgical care to meet the patient care need of pain management.Implications for the profession and/or patient care: The developed questionnaire addresses the need of nurses and nursing leaders to evaluate the delivery of person-centred pain management in acute surgical care, to relieve the patient from pain.Patient or public contribution: Patients and providers were involved in testing the questionnaire.
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| 3. |
- Avallin, Therese, et al.
(författare)
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Person-centred pain management for the patient with acute abdominal pain : An ethnography informed by the Fundamentals of Care framework
- 2018
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 74:11, s. 2596-2609
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To explore and describe the impact of the organizational culture on and the patient-practitioner patterns of actions that contributes to or detract from successful pain management for the patient with acute abdominal pain (AAP) across the acute care pathway.Background: Although pain management is a recognized human right, unmanaged pain continues to cause suffering and prolong hospital care. Unanswered questions about how to successfully manage pain relate to both organizational culture and individual practitioners' performance.Design: Focused ethnography, applying the Developmental Research Sequence and the Fundamentals of Care framework.Methods: Participant observation and informal interviews (92hr) were performed at one emergency department (ED) and two surgical wards at a University Hospital during April-November 2015. Data include 261 interactions between patients, aged 18years seeking care for AAP at the ED and admitted to a surgical ward (N=31; aged 20-90years; 14 men, 17 women; 9 with communicative disabilities) and healthcare practitioners (N=198).Results: The observations revealed an organizational culture with considerable impact on how well pain was managed. Well-managed pain presupposed the patient and practitioners to connect in a holistic pain management including a trustful relationship, communication to share knowledge and individualized analgesics.Conclusions: Person-centred pain management requires an organization where patients and practitioners share their knowledge of pain and pain management as true partners. Leaders and practitioners should make small behavioural changes to enable the crucial positive experience of pain management.
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| 4. |
- Avallin, Therese, et al.
(författare)
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Testing a model for person-centred pain management : A systematic review and synthesis guided by the Fundamentals of Care framework
- 2023
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 32:19-20, s. 6811-6832
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Tidskriftsartikel (refereegranskat)abstract
- AimsTo test a model for person-centred pain management using qualitative evidence in the literature and refine it based on the results.DesignA qualitative systematic review with thematic synthesis using the Fundamentals of Care framework.Methods and Data SourcesA literature search in February 2021 in six scientific databases: CINAHL, PsycInfo, Pubmed, Scopus, Social Science Premium Collection and Web of Science, reported using ENTREQ and PRISMA. Quality assessment was performed for the individual studies. Thematic analysis and the GRADE-CERQual approach were used in the synthesis including the assessment of confidence in the evidence.ResultsThe model was tested against the evidence in 15 studies appraised with moderate or high quality and found represented in the literature but needed to be expanded. A refined model with a moderate/high confidence level of evidence presents elements to be used in a holistic care process; The nurse is guided to establish a trusting relationship with the patient and enable communication to identify and meet pain management needs using pharmacological and non-pharmacological management. Nurse leaders are guided to support this process by providing the right contextual conditions.ConclusionsThe strengths of the confidence level in the refined model, and that it is represented from the nurse and patient perspectives in nursing research across countries and cultures, support our recommendation for empirical evaluation.Implications for the Profession and/or Patient CareThe model links the knowledge of pain management elements from individual studies together into actions to be performed in clinical practice. It also outlines the organizational support needed to make this happen. Nurses and nursing leaders are suggested to test the model to implement person-centred pain management in clinical practice.Patient or Public ContributionNo patient or public contribution.ImpactWhat Problem Did the Study Address? There is a need to transfer available evidence of person-centred pain management into practice to relieve the patient from pain. What Were the Main Findings? Person-centred pain management is of high priority for patients and nurses around the world and can be performed in a holistic care process including patient–nurse trust and communication, supported by contextual conditions to deliver timely pharmacological and non-pharmacological pain management addressing the patient's physical, psychosocial and relational care needs. Where and on Whom will the Research Have an Impact? The model is to be tested and evaluated in clinical practice to guide the providers to relieve the patient from pain.Reporting MethodRelevant EQUATOR guidelines were used to report the study: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.
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| 5. |
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| 6. |
- Feo, Rebecca, et al.
(författare)
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Towards a standardised definition for fundamental care : a modified Delphi study
- 2018
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Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 27:11-12, s. 2285-2299
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Tidskriftsartikel (refereegranskat)abstract
- AIMS: To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care.BACKGROUND: There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus.DESIGN: Modified Delphi study.METHODS: Three phases: (1) engaging stakeholders via an interactive workshop; (2) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (3) gaining consensus on the definition and elements via a two-round Delphi approach (Round 1 n=38; Round 2 n=28).RESULTS: Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse-patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific.CONCLUSIONS: This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users. This article is protected by copyright. All rights reserved.
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| 7. |
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| 8. |
- Jangland, Eva, et al.
(författare)
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Patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode : a multi-stage qualitative case study
- 2016
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 72:4, s. 791-801
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To explore how patients with acute abdominal pain describe their experiences of fundamental care across the acute care episode.BACKGROUND: Acute abdominal pain is one of the most common conditions to present in the acute care setting. Little is known about how patients' fundamental care needs are managed from presentation to post discharge.DESIGN: A multi-stage qualitative case study using the Fundamentals of Care framework as the overarching theoretical and explanatory mechanism.METHODS: Repeated reflective interviews were conducted with five adult patients over a 6-month period in 2013 at a university hospital in Sweden. The interviews (n = 14) were analysed using directed content analysis.RESULTS: Patients' experiences across the acute care episode are presented as five patient narratives and synthesized into five descriptions of the entire hospital journey. The patients talked about the fundamentals of care and had vivid accounts of what they meant to them. The experiences of each of the patients were influenced by the extent to which they felt engaged with the health professionals. The ability to engage or build a rapport was identified as a central component across the fundamental care elements, but it varied in visibility.CONCLUSION: Consistent pain management, comfort, timely and accurate information, choice and dignity and relationships were identified as essential fundamental care needs of patients experiencing acute abdominal pain regardless of setting, diagnosis, or demographic variables. These were variously achieved and the patients' narratives raised areas for improvement in several areas.
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| 9. |
- Jeffs, Lianne, et al.
(författare)
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Building the Foundation to Generate a Fundamental Care Standardized Data Set
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 27:11-12, s. 2481-2488
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Tidskriftsartikel (refereegranskat)abstract
- Considerable transformation is occurring in healthcare globally with organizations focusing on achieving the quadruple aim of improving the experience of care, the health of populations, and the experience of providing care while reducing per capita costs of health care. In response, health care organizations are employing performance measurement and quality improvement methods to achieve the quadruple aim. Despite the plethora of measures available to health managers, there is no standardized data set and virtually no indicators reflecting how patients actually experience the delivery of fundamental care, such as nutrition, hydration, mobility, respect, education, and psychosocial support. Given the linkages of fundamental care to safety and quality metrics, efforts to build the evidence base and knowledge that captures the impact of enacting fundamental care across the health care continuum and lifespan should include generating a routinely collected data set of relevant measures. This paper provides an overview of the current state of performance measurement, key trends, and a methodological approach to leverage in efforts to generate a standardized data set for fundamental care.
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| 10. |
- Khoddam, Homeira, et al.
(författare)
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Knowledge translation in health care : a concept analysis
- 2014
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Ingår i: Medical Journal of the Islamic Republic of Iran. - 1016-1430 .- 2251-6840. ; 28
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Tidskriftsartikel (refereegranskat)abstract
- Background:Although knowledge translation is one of the most widely used concepts in health and medicalliterature, there is a sense of ambiguity and confusion over its definition. The aim of this paper is to clarify thecharacteristics of KT. This will assist the theoretical development of it and shape its implementation into thehealth care systemMethods:Walker and Avant’s framework was used to analyze the concept and the related literature publishedbetween 2000 and 2010 was reviewed. A total of 112 papers were analyzed.Results:Review of the literature showed that "KT is a process" and "implementing refined knowledge into aparticipatory context through a set of challenging activities" are the characteristics of KT. Moreover, to occursuccessfully, KT needssome necessary antecedents like an integrated source of knowledge, a receptive context,and preparedness. The main consequence of successful process is a change in four fields of healthcare, i.e. quali-ty of patient care, professional practice, health system, and community. In addition, this study revealed someempirical referents which are helpful to evaluate the process.Conclusion:By aiming to portray a clear picture of KT, we highlighted its attributes, antecedents, conse-quences and empiricalreferents. Identifying the characteristics of this concept may resolve the existing ambigui-ties in its definition and boundaries thereby facilitate distinction from similar concepts. In addition, these find-ings can be used as a knowledge infrastructure fordeveloping the KT-related models, theories, or tools.
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| 11. |
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| 12. |
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| 13. |
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| 14. |
- Kitson, Alison, et al.
(författare)
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Anything but basic : Nursing’s challenge in meeting patients' fundamental care needs
- 2014
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Ingår i: Journal of Nursing Scholarship. - : Wiley. - 1527-6546 .- 1547-5069. ; 46:5, s. 331-339
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Tidskriftsartikel (refereegranskat)abstract
- PurposeNursing has not explored the fundamental aspects of patient care in a systematic, conceptually coherent, scientific way, and this has created a number of ongoing challenges.Organizing ConstructEach challenge is identified and addressed in the form of a proposition, with evidence provided to support the arguments put forward and defend the proposed actions.FindingsThe challenges include: the need for an integrated way of thinking about the fundamentals of care from a conceptual, methodological, and practical perspective; the ongoing and unresolved tension in nursing practice between a depersonalized and mechanistic approach (termed a “task and time” driven culture) and the need for consistency around understanding and managing the dynamics of the nurse–patient relationship or encounter (termed a “thinking and linking” approach); and the need for a systematic approach to the fundamentals or basics of care that combines the physical, psychosocial, and relational dimensions of the care encounter within the wider context of the care environment. Pragmatic and practical frameworks are needed to ensure that the basic physical and psychosocial needs of patients are embedded not only in the practice but also in the thinking, reflection, and assessment processes of the nurse.ConclusionsNursing's challenge to meet patients’ basic or fundamental needs is complex. Developing a knowledge base will include identifying researchable questions, using rigorous methodologies, ensuring the relational dimensions are not lost, and ensuring the new knowledge is applied in practice. This requires collaboration on an international scale to achieve improvements in care.Clinical RelevanceTo work collaboratively to generate, test, and implement meaningful ways of capturing nursing practice around basic or fundamental care in order to ensure more integrated, holistic patient care nursing practices.
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| 15. |
- Kitson, Alison, et al.
(författare)
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Defining the fundamentals of care
- 2010
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Ingår i: International Journal of Nursing Practice. - 1322-7114 .- 1440-172X. ; 16:4, s. 423-434
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Tidskriftsartikel (refereegranskat)abstract
- A three-stage process is being undertaken to investigate the fundamentals of care. Stage One (reported here) involves the use of a met a-narrative review methodology to undertake a thematic analysis, categorization and synthesis of selected contents extracted from seminal texts relating to nursing practice. Stage Two will involve a search for evidence to inform the fundamentals of care and a refinement of the review method. Stage Three will extend the reviews of the elements defined as fundamentals of care. This introductory paper covers the following aspects: the conceptual basis upon which nursing care is delivered; how the fundamentals of care have been defined in the literature and in practice; an argument that physiological aspects of care, self-care elements and aspects of the environment of care are central to the conceptual refinement of the term fundamentals of care; and that efforts to systematize such information will enhance overall care delivery through improvements in patient safety and quality initiatives in health systems.
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| 16. |
- Kitson, Alison, et al.
(författare)
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Development and preliminary testing of a framework to evaluate patients' experiences of the fundamentals of care : a secondary analysis of three stroke survivor narratives.
- 2013
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Ingår i: Nursing Research and Practice. - : Hindawi Limited. - 2090-1429 .- 2090-1437. ; 2013, s. 572437-
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To develop and test a framework describing the interrelationship of three key dimensions (physical, psychosocial, and relational) in the provision of the fundamentals of care to patients. Background. There are few conceptual frameworks to help healthcare staff, particularly nurses, know how to provide direct care around fundamental needs such as eating, drinking, and going to the toilet. Design. Deductive development of a conceptual framework and qualitative analysis of secondary interview data. Method. Framework development followed by a secondary in-depth analysis of primary narrative interview data from three stroke survivors. Results. Using the physical, psychosocial and relational dimensions to develop a conceptual framework, it was possible to identify a number of "archetypes" or scenarios that could explain stroke survivors' positive experiences of their care. Factors contributing to suboptimal care were also identified. Conclusions. This way of thinking about how the fundamentals of care are experienced by patients may help to elucidate the complex processes involved around providing high quality fundamentals of care. This analysis illustrates the multiple dimensions at play. However, more systematic investigation is required with further refining and testing with wider healthcare user groups. The framework has potential to be used as a predictive, evaluative, and explanatory tool.
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| 17. |
- Kitson, Alison L., et al.
(författare)
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‘No more heroes’ : The ILC Oxford Statement on fundamental care in times of crises
- 2023
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 79:3, s. 922-932
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Forskningsöversikt (refereegranskat)abstract
- AimTo outline the International Learning Collaborative (ILC) Oxford Statement, explicating our commitment to ensuring health and care systems are equipped to meet patients' fundamental care needs during times of unprecedented crisis. Design/MethodDiscussion paper. The content was developed via a co-design process with participants during the ILC's international conference. Key ArgumentsWe, the ILC, outline what we do and do not want to see within our health and care systems when faced with the challenges of caring for patients during global pandemics and other crises. Specifically, we want fundamental care delivery to be seen as the minimum standard rather than the exception across our health and care systems. We want nursing leaders to call out and stand up for the importance of building fundamental care into systems, processes and funding priorities. We do not want to see the voices of nursing leaders quashed or minimized in favour of other agendas. In turn, what we want to see is greater recognition of fundamental care work and greater respect for the people who do it. We expect nurses to have a 'seat at the table' where the key health and care decisions that impact patients and staff are made. ConclusionTo achieve our goals we must (1) ensure that fundamental care is embedded in all health and care systems, at all levels; (2) build on and strengthen the leadership skills of the nursing workforce by clearly advocating for person-centred fundamental care; (3) co-design systems that care for and support our staff's well-being and which foster collective resilience rather than overly rely on individual resilience; (4) improve the science and methodologies around reporting and measuring fundamental care to show the positive impact of this care delivery and (5) leverage the COVID pandemic crisis as an opportunity for transformational change in fundamental care delivery.
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| 18. |
- Kitson, Alison, et al.
(författare)
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Lessons from COVID
- 2021
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Ingår i: Journal of Advanced Nursing. - : John Wiley & Sons. - 0309-2402 .- 1365-2648. ; 77:7, s. e7-e9
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 19. |
- Kitson, Alison, et al.
(författare)
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Speaking Up for Fundamental Care : the ILC Aalborg Statement
- 2019
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 9:12
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The International Learning Collaborative (ILC) is an organisation dedicated to understanding why fundamental care, the care required by all patients regardless of clinical condition, fails to be provided in healthcare systems globally. At its 11th annual meeting in 2019, nursing leaders from 11 countries, together with patient representatives, confirmed that patients' fundamental care needs are still being ignored and nurses are still afraid to 'speak up' when these care failures occur. While the ILC's efforts over the past decade have led to increased recognition of the importance of fundamental care, it is not enough. To generate practical, sustainable solutions, we need to substantially rethink fundamental care and its contribution to patient outcomes and experiences, staff well-being, safety and quality, and the economic viability of healthcare systems.KEY ARGUMENTS: We present five propositions for radically transforming fundamental care delivery:Value: fundamental care must be foundational to all caring activities, systems and institutionsTalk: fundamental care must be explicitly articulated in all caring activities, systems and institutions.Do: fundamental care must be explicitly actioned and evaluated in all caring activities, systems and institutions.Own: fundamental care must be owned by each individual who delivers care, works in a system that is responsible for care or works in an institution whose mission is to deliver care.RESEARCH: fundamental care must undergo systematic and high-quality investigations to generate the evidence needed to inform care practices and shape health systems and education curricula.CONCLUSION: For radical transformation within health systems globally, we must move beyond nursing and ensure all members of the healthcare team-educators, students, consumers, clinicians, leaders, researchers, policy-makers and politicians-value, talk, do, own and research fundamental care. It is only through coordinated, collaborative effort that we will, and must, achieve real change.
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| 20. |
- Kitson, Alison, et al.
(författare)
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Stroke survivors’ experiences of the fundamentals of care : A qualitative analysis
- 2013
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489 .- 1873-491X. ; 50:3, s. 392-403
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundManaging the fundamentals of care (e.g. elimination, personal hygiene, eating,) needs to be more explicitly addressed within the patient-centred care discourse. It is not possible to investigate issues of patient dignity and respect without acknowledging these basic physical needs. While the literature on caring for people with a stroke is extensive, no studies to date have described stroke survivors’ experiences of all of these fundamentals during the in-hospital phase of their care.DesignSecondary analysis of qualitative data grounded in interpretative phenomenology Participants and settings: Fifteen stroke survivors with in-hospital experiences from multiple healthcare settings and healthcare professionals across the United Kingdom were included.MethodA secondary thematic analysis of primary narrative interview data from stroke survivors.ResultsSurvivors of strokes have vivid and often distressing recollections of their experiences of the fundamentals of care. For every description of a physical need (elimination, eating and drinking, personal hygiene) there where lucid accounts of the psychosocial and emotional impact (humiliation, distress, lack of dignity, recovery, confidence). Linked to the somatic and emotional dimensions were narratives around the relationship between the patient and the carer (nurse, doctor, allied health professional). Positive recollections of the fundamentals of care were less evident than more distressing experiences. Consistent features of positive experiences included: stroke survivors describing how the physical, psychosocial and relational dimensions of care were integrated and coordinated around their particular need. They reported feeling involved in setting achievable targets to regain control of their bodily functions and regain a sense of personal integrity and sense of self. Sociological constructs such as biographical disruption and loss of self were found to be relevant to stroke survivors’ experiences. Indeed, such constructs may be more linked to the disruption of such fundamental activities rather than the experience of the illness itself.ConclusionsWe recommend more practical and integrated approaches be taken around understanding and meeting the physical, psychosocial and relational needs of patients in hospital which could lead to more patient-centred care experiences. These three dimensions need to co-exist in every care episode. More exploration is required to identify the common fundamentals of care needs of patients regardless of illness experience.
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| 21. |
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| 22. |
- Kitson, Alison, et al.
(författare)
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What’s my line? : A narrative review and synthesis of the literature on Registered Nurses' communication behaviours between shifts
- 2014
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 70:6, s. 1228-1242
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Forskningsöversikt (refereegranskat)abstract
- AimTo describe, appraise and synthesize the seminal and empirical literature around Registered Nurses' communication behaviours between shifts in acute hospital settings.BackgroundEffective communication between shifts (at nursing handover) is acknowledged as a prerequisite to safe and high-quality patient-centred care. However, gaps and inconsistencies continue to prevail.DesignNarrative review and synthesis.Data sourcesThe electronic databases PubMED, CINAHL and Scopus were used.Review methodsEnglish language, peer-reviewed papers published between 1970–April 2012 were considered for review. Criteria included Registered Nurses' communication during handovers in adult hospital settings.ResultsTwenty-nine papers were reviewed. The research lacks a clear conceptual framework to define the core purposes of Nurses' communication behaviours between shifts. Seven themes were identified: overall purpose; report givers and receivers; seeing the whole picture; teaching and education; language; patient-centred care; and social cohesion. Two main communication processes are required – one articulating the whole picture and the other detailing information about patients.ConclusionThis area of research is challenged by lack of consistency in terminology and methodological rigour. While recent research has confirmed the findings from the seminal work, it has not been able to elaborate on some of the key challenges to refine the knowledge base. A more integrated approach is required to understand the complex process of improving nursing communication behaviours, particularly around the nursing handover. A neglected area of study is the role of the unit lead in determining the communication standards of the whole nursing team.
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| 23. |
- Muntlin Athlin, Åsa, 1971-, et al.
(författare)
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Descriptions of Fundamental Care needs in cancer care - an exploratory study
- 2018
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 27:11-12, s. 2322-2332
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To explore the experiences of the fundamentals of care for people with a cancer diagnosis, from diagnosis to after adjuvant treatment.BACKGROUND: More focus is needed on the experience of people living with cancer, as current cancer care more emphasises on independence and resilience without fully acknowledging that there will be moments in the cancer journey where patients will need 'basic nursing care' to manage their symptoms and care pathways.DESIGN: Secondary analysis of qualitative data.METHOD: Secondary thematic analysis of interview data from 30 people with a diagnosis of breast (n=10), colorectal (n=10) or prostate (n=10) cancer was undertaken.RESULTS: The findings revealed vivid descriptions of the fundamentals of care (i.e. basic needs) and participants described physical, psychosocial and relational aspects of the delivery of care. Both positive (e.g. supportive and kind) and negative (e.g. humiliating) experiences related to the relationship with the healthcare professionals were re-counted and affected the participants' experiences of the fundamentals of care. Participants' accounts of their fundamental care needs were provided without them identifying who, within the health care system, was responsible for providing these needs. Specific nursing interventions were seldom described.CONCLUSION: Some people with a cancer diagnosis have to strive for help and support from the nursing staff to manage to regain control over their recovery. Nurses in cancer care need to focus on the patients' fundamental care needs to optimise their patients' recovery. This article is protected by copyright. All rights reserved.
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| 24. |
- Seers, Kate, et al.
(författare)
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FIRE (Facilitating Implementation of Research Evidence) : a study protocol
- 2012
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Ingår i: Implementation Science. - : BioMed Central (BMC). - 1748-5908. ; 7:25
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Research evidence underpins best practice, but is not always used in healthcare. The Promoting Action on Research Implementation in Health Services (PARIHS) framework suggests that the nature of evidence, the context in which it is used, and whether those trying to use evidence are helped (or facilitated) affect the use of evidence. Urinary incontinence has a major effect on quality of life of older people, has a high prevalence, and is a key priority within European health and social care policy. Improving continence care has the potential to improve the quality of life for older people and reduce the costs associated with providing incontinence aids. OBJECTIVES: This study aims to advance understanding about the contribution facilitation can make to implementing research findings into practice via: extending current knowledge of facilitation as a process for translating research evidence into practice; evaluating the feasibility, effectiveness, and cost-effectiveness of two different models of facilitation in promoting the uptake of research evidence on continence management; assessing the impact of contextual factors on the processes and outcomes of implementation; and implementing a pro-active knowledge transfer and dissemination strategy to diffuse study findings to a wide policy and practice community. SETTING AND SAMPLE: Four European countries, each with six long-term nursing care sites (total 24 sites) for people aged 60 years and over with documented urinary incontinence METHODS AND DESIGN: Pragmatic randomised controlled trial with three arms (standard dissemination and two different programmes of facilitation), with embedded process and economic evaluation. The primary outcome is compliance with the continence recommendations. Secondary outcomes include proportion of residents with incontinence, incidence of incontinence-related dermatitis, urinary tract infections, and quality of life. Outcomes are assessed at baseline, then at 6, 12, 18, and 24 months after the start of the facilitation interventions. Detailed contextual and process data are collected throughout, using interviews with staff, residents and next of kin, observations, assessment of context using the Alberta Context Tool, and documentary evidence. A realistic evaluation framework is used to develop explanatory theory about what works for whom in what circumstances. TRIAL REGISTRATION: Current Controlled Trials ISRCTN11598502.
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| 25. |
- Wallin, Lars
(författare)
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Knowledge Utilisation in Swedish Neonatal Nursing : Studies on Guideline Implementation, Change Processes and Contextual Factors
- 2003
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to study the implementation of guidelines, change processes and contextual variables from the perspective of improvements and neonatal nursing care’s endeavours to be more evidenced-based. Because health care is exposed to extensive change pressure and because the impact of effectiveness research on clinical practice is limited, it becomes urgent to understand how knowledge utilisation initiatives can be facilitated.Three studies involved managers and nurses at all neonatal units in Sweden. Two of these studies also included nurses from other healthcare organisations. The fourth study included all staff at four neonatal units. The study designs used were cross-sectional, comparative and prospective longitudinal surveys; questionnaires were used as data collection tools in all four studies.Evaluation of the utilisation of the neonatal nursing guidelines showed that the guidelines were known to the nurse managers and used at most of the units, though to varying degrees and in different ways. Fifteen months after guideline dissemination, 8 of 35 units had changed practice, of which 2 units had completed the implementation process of a guideline. Involvement in the preceding guideline project facilitated the completion of improvement projects compared with participation in training courses for quality improvement (QI) only. There was no difference between these two groups on long-standing involvement in improvement work. Nurses who continued QI work over a 4-year period were more active in seeking research and implementing research findings in clinical practice than those who ceased the improvement work. The QI-sustainable nurses reported better contextual support for research-related activities. In a separate study staff perceptions of organisational factors appeared stable over the course of one year at the aggregated level. Improvements in skills development and participatory management predicted higher overall organisational and staff well-being. The findings emphasize the importance of including both individual and organisational factors in the strategic planning for evidence-based nursing. Plans have to be long-term and consider that change is a slow process. Leadership commitment is essential and there are clear benefits in developing a learning and professional supportive environment as well as of involving staff in organisational decision making.
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