Elucidating strategies used by clinical nurse leaders to facilitate fundamental care delivery: A qualitative study.
care
leadership
nurse roles
qualitative approaches
staff development
Journal
Journal of advanced nursing
ISSN: 1365-2648
Titre abrégé: J Adv Nurs
Pays: England
ID NLM: 7609811
Informations de publication
Date de publication:
Mar 2023
Mar 2023
Historique:
revised:
11
05
2022
received:
28
11
2021
accepted:
06
06
2022
pubmed:
13
7
2022
medline:
14
3
2023
entrez:
12
7
2022
Statut:
ppublish
Résumé
To investigate the strategies used by nurse leaders to facilitate fundamental care delivery in their clinical area. An interpretative qualitative design study reported in line with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Twenty-four self-identified nurse leaders from across Australia were interviewed between November 2020 and April 2021 to discuss their strategies for facilitating fundamental care. Data was analysed using inductive thematic analysis. Nurse leaders' experience of facilitating fundamental care produced two major themes, delivery of fundamental care (comprising three sub-themes: valuing fundamental care, understanding and developing staff capacity and supportive relationships), and monitoring of fundamental care (including three sub-themes: visibility in the clinical area, embedding fundamental care in the practice setting and specific direct actions). Facilitating fundamental care delivery is complex. This study highlighted the importance of nurse leaders' individual characteristics, and nurse leaders' ability to establish and maintain relationships alongside the role of informal and formal monitoring of fundamental care delivery. Findings from this study build on existing research into fundamental care and contribute to our understanding of the role, characteristics and actions of nurse leaders to facilitate fundamental care. The results demonstrate the complexity and intricacy of nursing leadership to facilitate fundamental care, and that a dynamic 'thinking and linking' approach is required. The results show individualized practice which may create challenges for new nurse leaders seeking guidance, and for monitoring nurse leader activity. Further research is advocated to explore insights and tools to optimize nurse leaders' endeavours in facilitating fundamental care. This study was designed using insights generated from patient and public involvement in nursing leadership and fundamental care.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1069-1081Subventions
Organisme : Nurses' Memorial Foundation of South Australia Limited
ID : Research Grant 2020
Informations de copyright
© 2022 John Wiley & Sons Ltd.
Références
Antrobus, S., & Kitson, A. (1999). Nursing leadership: Influencing and shaping health policy and nursing practice. Journal of Advanced Nursing, 29, 746-753.
Berkow, S., Workman, J., Aronson, S., Stewart, J., Virkstis, K., & Kahn, M. (2012). Strengthening frontline nurse Investment in Organizational Goals. Journal of Nursing Administration, 42(3), 165-169. https://doi.org/10.1097/NNA.0b013e31824809b7
Conroy, T. (2018). Factors influencing the delivery of the fundamentals of care: Perceptions of nurses, nursing leaders and healthcare consumers. Journal of Clinical Nursing., 27(11-12), 2373-2386. https://doi.org/10.1111/jocn.14183
Conroy, T., Pinero de Plaza, M. A., Mudd, A., Mitchell, M., & Kitson, A. (2021). Measuring fundamental care using complexity science: A descriptive case study of a methodological innovation. Journal of Clinical Nursing, 1-10. https://doi.org/10.1111/jocn.10905
Creswell, J. W. (2007). Qualitative Inquiry & Reearch Design: Choosing among five approaches (2nd ed.). SAGE Publications Inc.
Douw, G., Schoonhoven, L., Holwerda, T., Huisman-de Waal, G., van Zanten, A. R., van Achterberg, T., & van der Hoeven, J. G. (2015). Nurses' worry or concern and early recognition of deteriorating patients on general wards in acute care hospitals: A systematic review. Critical Care, 19(1), 1-11. https://doi.org/10.1186/s13054-015-0950-5
Elo, S., & Kyngas, H. (2008). The qualitative content analysis process. Journal of Advanced Nursing, 62, 107-115. https://doi.org/10.1111/j.1365-2648.2007.04569.x
Feo, R., Conroy, T., Alderman, J., & Kitson, A. (2017). Implementing fundamental care in clinical practice. Nursing Standard, 32, 52-62. doi:10.7748/ns.2017.e10765
Feo, R., Conroy, T., Alderman, J., & Kitson, A. (2021). In J. Crisp, C. Douglas, G. Rebeiro, & D. Waters (Eds.), Engaging patients and keeping them safe, in Potter & Perry's fundamentals of nursing: Australia and New Zealand 6th edition (6th ed., pp. 34-48). Elsevier Australia.
Feo, R., Conroy, T., Jangland, E., Muntlin Athlin, Å., Brovall, M., Parr, J., Blomberg, K., & Kitson, A. (2018). Towards a standardised definition for fundamental care: A modified Delphi study. Journal of Clinical Nursing, 27(11-12), 2285-2299. https://doi.org/10.1111/jocn.14247
Gifford, W. A., Squires, J. E., Angus, D. E., Ashley, L. A., Brosseau, L., Craik, J. M., & Graham, I. D. (2018). Managerial leadership for research use in nursing and allied health care professions: A systematic review. Implementation Science, 13(1), 127. https://doi.org/10.1186/s13012-018-0817-7
Gillespie, A., & Reader, T. W. (2018). Patient-centered insights: Using health care complaints to reveal hot spots and blind spots in quality and safety. Milbank Quarterly, 96(3), 530-567. https://doi.org/10.1111/1468-0009.12338
Groves, A., Thompson, D., McKellar, D., & Procter, N. (2017). The Oakden report. Department for Health and Ageing.
Jeffs, L., Muntlin Athlin, Å., Needleman, J., Jackson, D., & Kitson, A. (2018). Building the foundation to generate a fundamental care standardised data set. Journal of Clinical Nursing, 27(11-12), 2481-2488. https://doi.org/10.1111/jocn.14308
Kitson, A., Carr, D., Conroy, T., Feo, R., Grønkjaer, M., Huisman-de Waal, G., Jackson, D., Jeffs, L., Merkley, J., Muntlin Athlin, Å., Parr, J., Richards, D., Sørensen, E., & Wengström, Y. (2019). Speaking up for fundamental care: The ILC Aalborg statement. BMJ Open, 9(12), e033077. https://doi.org/10.1136/bmjopen-2019-033077
Kitson, A., Conroy, T., Kuluski, K., Locock, L., & Lyons, R. (2013). Reclaiming and redefining the fundamentals of care: Nursing's response to meeting patients' basic human needs. School of Nursing, the University of Adelaide. https://thesis.library.adelaide.edu.au/dspace/bitstream/2440/75843/1/hdl_75843.pdf
Kitson, A., Muntlin Athlin, Å., & Conroy, T. (2014). Anything but basic: Nursing's challenge in meeting patients' fundamental care needs. Journal of Nursing Scholarship, 46, 331-339. https://doi.org/10.1111/jnu.12081
Kitson, A. L., Harvey, G., Gifford, W., Hunter, A. C., Kelly, J., Cummings, G. C., Ehrenberg, A., Kislov, R., Pettersson, L., Wallin, L., & Wilson, P. (2021). How nursing leaders promote evidence-based practice implementation at point-of-care: A four-country exploratory study. Journal of Advanced Nursing, 77, 2447-2457. https://doi.org/10.1111/jan.14773
Maben, J., Peccei, R., Adams, M., Robert, G., Richardson, A., Murrells, T., & Morrow, E. (2012). Exploring the relationship between patients' experiences of care and the influence of staff motivation, affect and wellbeing. In National Institute for Health Research, service delivery and organisation Programme. National Institute for Health Research.
McCauley, L., Kirwan, M., Riklikiene, O., & Hinno, S. (2020). A scoping review: The role of the nurse manager as represented in the missed care literature. Journal of Nursing Management, 28, 1770-1782.
Mudd, A., Feo, R., Conroy, T., & Kitson, A. (2020). Where and how does fundamental care fit within seminal nursing theories: A narrative review and synthesis of key nursing concepts. Journal of Clinical Nursing, 29(19-20), 3652-3666. https://doi.org/10.1111/jocn.15420
Muntlin Athlin, Å., Brovall, M., Wengström, Y., Conroy, T., & Kitson, A. (2018). Descriptions of fundamental care needs in cancer care-an exploratory study. Journal of Clinical Nursing, 11-12, 2322-2332. https://doi.org/10.1111/jocn.14251
Nursing and Midwifery Board of Australia. (2018). Code of conduct for nurses. https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/frameworks.aspx
Nursing and Midwifery Board of Australia. (2020). Decision making framework for nursing and midwifery https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/frameworks.aspx
Pegram, A. M., Grainger, M., Sigsworth, J., & While, A. E. (2014). Strengthening the role of the ward manager: A review of the literature. Journal of Nursing Management, 22(6), 685-696. https://doi.org/10.1111/jonm.12047
Rantz, M. J., Grando, V., Conn, V., Zwygart-Staffacher, M., KHicks, L., Flesner, M., Scott, J., Manion, P., Minner, D., Porter, R., & Mass, M. (2003). Getting the basics right. Journal of Gerontological Nursing, 29(11), 15-25. https://doi.org/10.3928/0098-9134-20031101-07
Richards, D. A., Hilli, A., Pentecost, C., Goodwin, V. A., & Frost, J. (2018). Fundamental nursing care: A systematic review of the evidence on the effect of nursing care interventions for nutrition, elimination, mobility and hygiene. Journal of Clinical Nursing, 27(11-12), 2179-2188. https://doi.org/10.1111/jocn.14150
Royal Commission on Aged Care Quality and Safety, (2019) Interim report: Neglect. Commonwealth of Australia, accessed 15th April 2020, https://agedcare.royalcommission.gov.au/publications/Documents/interim-report/interim-report-volume-1.pdf
Ryan, F., Coughlan, M., & Cronin, P. (2007). Step-by-step guide to critiquing research. Part 2: Qualitative research. British Journal of Nursing, 16, 738-744. https://doi.org/10.12968/bjon.2007.16.11.23681
Ryder, M., Kitson, A. L., O'Brien, T. S., & Timmins, F. (2021). Advancing nursing practice through fundamental care delivery. Journal of nursing management., 30, 601-603. https://doi.org/10.1111/jonm.13402
Sorensen, R., Iedema, R., & Severinsson, E. (2008). Beyond profession: Nursing leadership in contemporary healthcare. Journal of Nursing Management, 16, 535-544. https://doi.org/10.1111/j.1365-2834.2008.00896.x
The National Health and Medical Research Council, the Australian Research Council and the Australian Vice-Chancellors' Committee (2018) National Statement on Ethical Conduct in Human Research https://www.nhmrc.gov.au/about-us/publications/national-statement-ethical-conduct-human-research-2007-updated-2018
Vollman, K. (2013). Interventional patient hygiene: Discussion of the issues and a proposed model for implementation of the nursing care basics. Intensive and Critical Care Nursing, 29, 250-255. https://doi.org/10.1016/j.iccn.2013.04.004
Wong, C., & Cummings, G. (2009). Authentic leadership: A new theory for nursing or back to basics? Journal of Health Organization and Management, 23(5), 522-538. https://doi.org/10.1108/14777260910984014
Wong, C., Cummings, G., & Ducharma, L. (2013). The relationship between nursing leadership and patient outcomes: A systematic review update. Journal of Nursing Management, 21, 709-724. https://doi.org/10.1111/jonm.12116