Faculty of Health, University of Technology, Sydney, NSW, Australia.
Department of Nursing Research & Practice Development, Faculty of Health, University of Technology, Sydney, NSW, Australia.
J Clin Nurs. 2017 Dec;26(23-24):4153-4171. doi: 10.1111/jocn.13957. Epub 2017 Sep 7.
To systematically review the literature describing factors perceived by nurses as impacting the provision of patient-centred nursing in the intensive care unit.
Patient-centred nursing in critical care differs from other healthcare areas, and the aggressive curative environment of the ICU has potential to compromise some of its elements. Understanding critical care, nurses' perceptions of promoting and deterrent factors may inform development of strategies to support effective patient-centred nursing and job satisfaction in this workforce.
An integrative literature review.
Whittemore and Knafl's method was used with "best-fit" framework synthesis. CINAHL, PsycINFO, Medline and EMBASE were searched for 2000-2016 literature using search terms drawn from the ICU patient-centred framework.
In total, 3,079 papers were identified, with 23 retained after applying eligibility criteria. Five themes were identified: Nurse identity; Organisation; Communication; Relationships; and Ideology of ICU. Almost every theme and related categories referred to factors acting as barriers to patient-centred nursing in the ICU; only four referred to supports/facilitators. Findings showed that provision of patient-centred nursing may be compromised by some factors of the critical care environment, and illustrate the challenges and complexity of providing effective patient-centred nursing in this environment.
Findings should be applied to address barriers and to enhance facilitators of effective patient-centred nursing in critical care. The emotional and physical demands of critical care nursing are major considerations; supporting these nurses to fulfil their challenging role may empower them in their professional quality of life and provide a basis for workforce retention as well as delivery of effective patient-centred nursing.
Measures to enhance patient-centred nursing could promote critical care nurses' job satisfaction and workforce retention, and be applied more broadly and collaboratively to promote multidisciplinary patient-centred care.
系统回顾文献，描述护士认为影响重症监护病房提供以患者为中心护理的因素。
重症监护中的以患者为中心的护理与其他医疗保健领域不同，重症监护病房积极的治疗环境有可能影响其某些要素。了解重症监护，护士对促进和阻碍因素的看法可能为制定支持该护理工作中有效以患者为中心的护理和工作满意度的策略提供信息。
综合文献综述。
使用 Whittemore 和 Knafl 方法和“最佳拟合”框架综合法。使用从 ICU 以患者为中心框架中提取的检索词，在 CINAHL、PsycINFO、Medline 和 EMBASE 中搜索 2000-2016 年的文献。
共确定了 3079 篇论文，应用入选标准后保留了 23 篇。确定了 5 个主题：护士身份；组织；沟通；关系；和 ICU 意识形态。几乎每个主题和相关类别都提到了 ICU 中以患者为中心的护理的障碍因素；只有 4 个提到了支持/促进因素。研究结果表明，重症监护环境的某些因素可能会影响以患者为中心的护理的提供，并说明了在这种环境中提供有效以患者为中心护理的挑战和复杂性。
研究结果应应用于解决以患者为中心的护理的障碍，并加强重症监护中的有效以患者为中心的护理的促进因素。重症监护护理的情感和身体需求是主要考虑因素；支持这些护士履行其具有挑战性的角色可以增强他们的专业生活质量，并为保留劳动力以及提供有效的以患者为中心的护理提供基础。
增强以患者为中心的护理措施可以提高重症监护护士的工作满意度和保留劳动力，并更广泛地协同应用，以促进多学科以患者为中心的护理。
