Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
J Clin Nurs. 2018 Jun;27(11-12):2230-2247. doi: 10.1111/jocn.14155. Epub 2017 Dec 19.
To examine and map research on minimum data sets linked to nursing practice and the fundamentals of care. Another aim was to identify gaps in the evidence to suggest future research questions to highlight the need for standardisation of terminology around nursing practice and fundamental care.
Addressing fundamental care has been highlighted internationally as a response to missed nursing care. Systematic performance measurements are needed to capture nursing practice outcomes.
Overview of the literature framed by the scoping study methodology.
PubMed and CINAHL were searched using the following inclusion criteria: peer-reviewed empirical quantitative and qualitative studies related to minimum data sets and nursing practice published in English. No time restrictions were set. Exclusion criteria were as follows: no available full text, reviews and methodological and discursive studies. Data were categorised into one of the fundamentals of care elements.
The review included 20 studies published in 1999-2016. Settings were mainly nursing homes or hospitals. Of 14 elements of the fundamentals of care, 11 were identified as measures in the included studies, but their frequency varied. The most commonly identified elements concerned safety, prevention and medication (n = 11), comfort (n = 6) and eating and drinking (n = 5).
Studies have used minimum data sets and included variables linked to nursing practices and fundamentals of care. However, the relations of these variables to nursing practice were not always clearly described and the main purpose of the studies was seldom to measure the outcomes of nursing interventions. More robust studies focusing on nursing practice and patient outcomes are warranted.
Using minimum data sets can highlight the nurses' work and what impact it has on direct patient care. Appropriate models, systems and standardised terminology are needed to facilitate the documentation of nursing activities.
检查并绘制与护理实践和基本护理相关的最小数据集的研究图谱。另一个目的是确定证据中的差距，提出未来的研究问题，以突出护理实践和基本护理术语标准化的必要性。
国际上强调解决基本护理问题是对护理缺失的回应。需要系统的绩效测量来捕捉护理实践结果。
根据范围综述研究方法概述文献。
使用以下纳入标准在 PubMed 和 CINAHL 上进行检索：与最小数据集和护理实践相关的同行评审实证定量和定性研究，以英文发表。没有设置时间限制。排除标准如下：无可用全文、综述以及方法学和论述性研究。数据被分类为基本护理要素之一。
综述包括 1999 年至 2016 年发表的 20 项研究。研究地点主要是疗养院或医院。在 14 项基本护理要素中，有 11 项在纳入的研究中被确定为测量要素，但它们的频率有所不同。最常被识别的要素涉及安全、预防和药物治疗（n=11）、舒适（n=6）和饮食（n=5）。
研究使用了最小数据集，并包含与护理实践和基本护理要素相关的变量。然而，这些变量与护理实践的关系并不总是明确描述的，研究的主要目的也很少是衡量护理干预的结果。需要更有力的研究来关注护理实践和患者结果。
使用最小数据集可以突出护士的工作以及其对直接患者护理的影响。需要适当的模型、系统和标准化术语来促进护理活动的记录。
