Fundamental care: bedside nurses’ perspective on the definition and its elements. A qualitative generic study.
Summary
Background: Fundamental care involves aspects of nursing care that refer to persons’ fundamental needs. Nurses have to operate in contexts where the focus is on efficiency and productivity, which pressurizes fundamental care. This results in fundamental care being delegated to allied health professionals, which is proven to influence patient outcomes negatively. Solid fundamental care is essential to improve nursing-sensitive patient outcomes. To improve these outcome measures, the Fundamentals of Care Framework (FoCF) was developed, which is based on the expertise of clinical and research members of the International Learning Collaborative but was never validated by bedside nurses.
Objective: To explore the perspective of bedside nurses on the definition of fundamental care, the elements of fundamental care, and how the FoCF can be used in clinical practice.
Method: A generic qualitative design was chosen. This study was performed in three hospitals; one university hospital and two general hospitals. Data were collected though focus groups with bedside nurses.
Results: The nurse-patient relationship was viewed as a central aspect in fundamental care. There was mentioned that fundamental care is patient-centred, trust-based, and has a holistic approach. Involving family and having respect for patients’ individual needs were recognized. Three dimensions of the FoCF were recognized, but some elements were not included in the physical dimension. The FoCF was viewed as essence of nursing, and participants mentioned it could be used as a tool for nursing students and nurses to identify bottlenecks in nursing care or to provide an overall picture of patients’ needs.
Recommendations: Further research must focus on the perspectives of bedside nurses working in other settings and in other countries, and it should focus on the integration of the FoCF in clinical practice to confirm the possible value of the framework in clinical practice and for nursing students.