School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden.
J Adv Nurs. 2022 Jul;78(7):2165-2174. doi: 10.1111/jan.15172. Epub 2022 Feb 7.
To explore how registered nurses in the emergency room describe their work approach and prerequisites for meeting life-threateningly ill patients' care needs from the perspective of a person-centred fundamental care framework.
A descriptive, qualitative interview study.
Individual interviews were carried out with 14 registered nurses with experience of working in an emergency room in Sweden, during 2019. Data were analysed using thematic analysis, according to Braun and Clarke. The COREQ checklist was used for reporting the findings.
Three themes were identified: Task-oriented nursing care based on structured guidelines and checklists; Fundamental care not being promoted or prioritized in the emergency room; and The organization and responsibilities for providing person-centred fundamental care are unclear. Results showed that registered nurses structure their work approach based on prevailing organizational prerequisites as well as personal ones. Meeting patients' fundamental care needs was not always prioritized; their physical needs were met to a greater extent than their relational and psychosocial needs. Registered nurses did not prioritize fundamental care when the organization did not.
From the registered nurses' perspective, they structured their work based on the prevailing conditions for meeting patients' fundamental care needs. The organizational structure does not clearly state that fundamental care should be performed in the emergency room, and the registered nurses' work approach there for meeting patients' fundamental care needs is not adapted to provide patients with person-centred care.
To date, little is known about registered nurses' work approach and prerequisites in meeting life-threateningly ill patients' fundamental care needs in the emergency room. Our findings indicate that the organizational structure is pivotal in supporting registered nurses to provide person-centred fundamental care. The knowledge from this study can be used in emergency care settings to facilitate person-centred fundamental care and thereby avoid fundamental care being missed.
从以人为本的基本护理框架的角度探讨急诊室注册护士如何描述其工作方法和满足生命垂危患者护理需求的前提条件。
描述性、定性访谈研究。
2019 年，对瑞典急诊室有工作经验的 14 名注册护士进行了个体访谈。根据 Braun 和 Clarke 的方法，使用主题分析对数据进行分析。使用 COREQ 清单报告研究结果。
确定了三个主题：基于结构化指南和检查表的任务导向护理；基本护理在急诊室没有得到促进或优先考虑；提供以人为本的基本护理的组织和责任不清楚。结果表明，注册护士根据现行组织前提条件和个人条件来构建他们的工作方法。满足患者的基本护理需求并不总是优先考虑的；他们的身体需求得到了更大程度的满足，而他们的关系和心理社会需求则没有得到满足。当组织不重视基本护理时，注册护士也不会重视基本护理。
从注册护士的角度来看，他们根据满足患者基本护理需求的现有条件来组织他们的工作。组织结构并未明确规定应在急诊室提供基本护理，因此，注册护士在那里满足患者基本护理需求的工作方法并不适应提供以患者为中心的护理。
迄今为止，人们对急诊室注册护士在满足生命垂危患者基本护理需求方面的工作方法和前提条件知之甚少。我们的研究结果表明，组织结构对于支持注册护士提供以患者为中心的基本护理至关重要。本研究的知识可用于急诊护理环境，以促进以人为本的基本护理，从而避免基本护理的缺失。
