Department of Surgical Sciences, Section of Nursing research, Uppsala University, Uppsala, Sweden.
Department of Surgery, Uppsala university hospital, Uppsala, Sweden.
PLoS One. 2024 Jul 2;19(7):e0304700. doi: 10.1371/journal.pone.0304700. eCollection 2024.
This research protocol presents an action research project with the aim to demonstrate the value of person-centred fundamental care to nurses and nurse managers in surgical care units to encourage a far-reaching change in this direction. The objectives are to describe this process and to evaluate the effects on missed nursing care and person-centred fundamental care.
In a novel collaboration between nursing science and medical humanities the action research design will be used to interact with nursing staff and leaders in three surgical care units and design interventions with the purpose to affect the direction of nursing. Initially, the care units will be presented with interactive workshops including evidence-based education on person-centered fundamental care, person-centredness, nurse role responsibility and leadership. This will be followed by cocreation of interventions to stimulate person-centered fundamental care. The Fundamentals of Care framework will be used as the overarching theoretical framework. Data on missed nursing care, person-centred climate and person-centered fundamental care will be collected repeatedly from patient- and nursing stakeholders through interviews and validated questionnaires. Additionally, data from written reflections following clinical observations and focus group interviews will be included. The duration of the study will be approximately five years from ethical approval.
It has been previously reported that the current working environments of registered nurses are forcing them to ration their caring responsibilities, leading to a lack of fulfillment of patients' fundamental care needs, with possible severe consequences for patients. The action research design helps researchers gain an understanding of the contextual factors important for forthcoming interventions, enabling reflective processes and cocreation of interventions with stakeholders. This may lead to feasible interventions and strengthen nursing leadership in the involved units.
本研究方案提出了一项行动研究项目,旨在向外科护理单元的护士和护士长展示以患者为中心的基础护理的价值,以鼓励朝着这个方向进行深远的变革。目的是描述这个过程,并评估对遗漏护理和以患者为中心的基础护理的影响。
在护理科学与医学人文学科之间的新颖合作中,将采用行动研究设计与三个外科护理单元的护理人员和领导进行互动,并设计干预措施以影响护理方向。最初,将向护理单元提供互动研讨会,包括以患者为中心的基础护理、以患者为中心、护士角色责任和领导力的循证教育。接下来,将共同创造干预措施以激发以患者为中心的基础护理。护理基础框架将作为总体理论框架。将通过访谈和经过验证的问卷,从患者和护理利益相关者那里反复收集关于遗漏护理、以患者为中心的氛围和以患者为中心的基础护理的数据。此外,还将包括临床观察和焦点小组访谈后的书面反思数据。从伦理批准开始,研究的持续时间约为五年。
先前有报道称,注册护士的当前工作环境迫使他们限制护理责任,导致患者的基本护理需求得不到满足,可能对患者造成严重后果。行动研究设计有助于研究人员了解对即将到来的干预措施很重要的背景因素,使他们能够进行反思过程并与利益相关者共同创造干预措施。这可能会导致可行的干预措施,并加强参与单位的护理领导力。