Aims and Objectives To determine nurses’ perceived barriers to the delivery of person‐centred care to complex patients with multiple chronic conditions in acute care settings. Background Complex patients have multiple physical and mental health problems, and their life is also greatly affected by sociocultural and economic determinants of health. These patients require person‐centred care, but nurses often find it challenging to provide effective care to these patients due to their complex health needs. Design A descriptive qualitative design was used. The COREQ guidelines were followed for reporting. Methods Semi‐structured interviews were conducted with a purposive sample of 19 nurses in two hospitals. Data were analysed using deductive thematic analysis guided by the Theoretical Domains Framework, which entails 14 domains about factors affecting behaviours. Results The key barriers were identified under environmental context and resources, social influences, emotions, knowledge and skills domains. Deep‐rooted social issues delay patients’ health‐seeking and nurses’ abilities to understand patients’ needs and discern appropriate care. Interpersonal hostility influenced nurse–patient–families interactions, and doctor–nurses conflicts affected collaborative efforts towards optimal care. Conclusions Nurses’ perceived barriers to care were intertwined with the deep‐rooted social and cultural beliefs about nurses’ image, patients’ expectations and families’ preference for home remedies over specialised nursing care. These barriers to person‐centred care demonstrate an intricate interplay of personal, social and organisational issues and power struggles. Multifaceted implementation strategies targeting environmental context and resources, social influences, emotions, knowledge and skills domains may be beneficial to enable nurses to provide better person‐centred care to complex patients. Relevance to clinical practice Designing implementation facilitation teams, organising person‐centred care grand rounds, and allocation of stress management resources to address hostility, social‐cultural influences, and organisational barriers is essential. Nurses could focus on their self‐awareness and collaborative skills to address emotional and interprofessional conflicts.
BackgroundSedation assessment and management is an essential part of critical care nursing. The patients are at significant risks of undersedation and oversedation. Critical care nurses must possess sufficient knowledge about sedation assessment and its management.AimThis study aimed to determine critical care nurses’ knowledge of sedation and its management in mechanically ventilated patients in Pakistan.MethodologyA cross-sectional descriptive study was conducted. The participants were recruited from three critical care units of a tertiary care hospital using a consecutive sampling technique. Data were collected using a self-administered questionnaire.FindingsIn total, 91 critical care nurses participated in this study. Most of them had less than 2 years of experience as registered nurses and as intensive care unit nurses. The majority of them had insufficient knowledge (poor knowledge 18.7% and fair knowledge 63.7%), whereas only 17.6% had good knowledge of sedation and its management. The average correct response rate for general knowledge of sedation management practices was 71.3%. Almost half of the participants (51.6%) had poor knowledge of assessing undersedation and oversedation. Overall, 67% of nurses had good knowledge of managing sedative drugs.ConclusionThe majority of critical nurses lacked sufficient knowledge related to sedation and its management in mechanically ventilated patients. This poses risks to patients’ safety and quality of care.
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