Nursing students' understanding of the Fundamentals of Care: A cross‐sectional study in five countries

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Objective:To explore how nurses in hospitals enact person-centred fundamental care delivery.Background: Effective person-centred care is at the heart of fundamental nursing care, but it is deemed to be challenging in acute health care as there is a strong biomedical focus and most nurses are not trained in person-centred fundamental care delivery. We therefore need to know if and how nurses currently incorporate a person-centred approach during fundamental care.Design: Focused ethnography approach.Methods: Observations of 30 nurses on three different wards in two Dutch hospitals during their morning shift. Data were collected through passive observations and analysed using framework analysis based on the fundamentals of care framework.The COREQ guideline was used for reporting.Results: Some nurses successfully integrate physical, psychosocial and relational elements of care in patient interactions. However, most nurses were observed to be mainly focused on physical care and did not take the time at their patients' bedside to care for their psychosocial and relational needs. Many had a task-focused way of working and communicating, seldom incorporating patients' needs and experiences or discussing care planning, and often disturbing each other. Conclusions:This study demonstrates that although some nurses manage to do so, person-centred fundamental care delivery remains a challenge in hospitals, as most nurses have a task-focused approach and therefore do not manage to integrate the physical, relational and physical elements of care. For further improvement, attention needs to be paid to integrated fundamental care and clinical reasoning skills.Relevance to clinical practice: Although most nurses have a compassionate approach, this study shows that nurses do not incorporate psychosocial care or encourage patient participation when helping patients with their physical fundamental care needs, even though there seems to be sufficient opportunity for them to do so.

Section: Discussionmentioning

confidence: 99%

Exploring person‐centred fundamental nursing care in hospital wards: A multi‐site ethnography

Belle¹,

Giesen²,

Conroy

et al. 2019

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“…It may even be necessary to address certain concepts from the beginning of the training so that the participants will concretely integrate the three dimensions into their learning. Several strategies to develop Fundamentals of Care and to implement the FOC framework in baccalaureate nursing education have been tried (Feo, Donnelly, Frensham, Conroy, & Kitson, ; Jangland et al, ; Voldbjerg et al, ). Of course, these attempts will be carefully considered for the development of training strategies based on the FOC‐PP.…”

Section: Methodsmentioning

confidence: 99%

Finding the fundamental needs behind resistance to care: Using the Fundamentals of Care Practice Process

Rey

Voyer

Bouchard

et al. 2019

A person living with Alzheimer's disease (PA) can experience difficulty during bodily care and therefore may show resistance to care behaviours (RTCBs). Nurses must take a clinical approach to planning care that meets the person's needs. Therefore, it is necessary to identify training strategies for bedside nurses and nursing students. Aims and objectives: To describe and discuss how the FOC practice process (FOC-PP) can help nurses understand PAs who show RTCBs during bodily care. Background: Resistance to care behaviour phenomenon and the importance of bodily care as fundamental care are described. The FOC-PP enables nurses to apply the FOC framework in their practice. Design: This discursive paper is based on the literature of the FOC framework and PP. Method: A clinical scenario that develops through the five stages of the FOC-PP. Results: The scenario centres on Mrs. Emily Morgan, 81, who lives in a nursing home and is not receiving the bodily care that she needs. Camille, a nursing student, and her supervisor Florence collaborate with Mrs. Morgan's family to improve the quality of her care. Three particular aspects of nursing practice based on the FOC-PP are described: the critical thinking process, relational process and pedagogical process. Conclusion: The FOC-PP promotes holistic care centred on the person and his or her needs and encourages the nurse to use his or her skills and knowledge. All these dimensions are fundamental for high-quality nursing care. Relevance to clinical practice: Mrs. Morgan's scenario enables us to perceive that the FOC-PP is very useful for nursing students and bedside nurses. However, given the amount of specific and diverse knowledge required by the FOC-PP, it is necessary to identify avenues for teaching them. Using clinical scenarios could facilitate the integration of the FOC-PP, with taking into account the specific characteristics of individual clients. K E Y W O R D S Fundamentals of Care Practice Process, needs, nursing, resistance to care | 1775 REY Et al.

“…Their results demonstrated that students face challenges in identifying a patient's care needs. Although Feo, Donnelly, et al () and Voldbjerg et al () described and discussed the process of embedding fundamental care within nursing curricula, Jangland et al () presented the initiatives taken to integrate the fundamentals of care framework into a baccalaureate nursing education. Moreover, the results from a pilot study conducted by Alderman et al () offered a practical and feasible way to explicitly embed the fundamentals of care into nursing curricula.…”

Section: Introductionmentioning

confidence: 99%

“A privilege but also a challenge.” Nurse educators' perceptions about teaching fundamental care in a simulated learning environment: A qualitative study

Lillekroken

2020

Aims and objectives:To explore nurse educators' perceptions about teaching fundamental care to undergraduate nursing students in a simulated learning environment.Background: Recent research has demonstrated that fundamental care is overlooked in nursing education, resulting in little empirical research on how to teach fundamental care within a simulated learning environment. Design:The study has a qualitative, explorative design. The principles of consolidated criteria for reporting qualitative research (COREQ) were applied for reporting the methods and findings.Methods: Data were collected through participant observations and focus group interviews with nursing students, clinical nurses and nurse educators. The data were analysed using the qualitative content analysis method.