Using communication to manage missed care: A case study applying the Fundamentals of Care framework

Avallin, Therese; Athlin, Åsa Muntlin; Björck, Martin; Jangland, Eva

doi:10.1111/jonm.12963

Cited by 34 publications

(28 citation statements)

References 28 publications

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“…When patients in this study asked for help to fulfil their nutritional needs and nurses failed to respond, some patients concluded that nutritional care was less important. This finding is supported by Avallin et al [39] 2020 who describe how feelings of being unimportant will restrain patients from expressing needs, resulting in missed care.…”

Section: Discussionmentioning

confidence: 80%

Dialogue is a prerequisite for the nurse–patient relationship in nutritional care: A secondary analysis using the fundamentals of care framework

Jensen

Nørholm

Poulsen

et al. 2022

Scandinavian Caring Sciences

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Background: Providing good nutritional care is complex as it goes beyond assessing and ensuring the patients' dietary needs. So far, nutritional research has mainly focused on establishing evidence for the nutritional treatment, while less attention has been on the complexity of providing nutritional care. The Fundamentals of Care (FoC) describes five elements (focus, knowledge, anticipate, evaluate and trust) essential for establishing a nurse-patient relationship as a foundation for quality care.By studying how these elements shape nutritional care and dialogue, we can explore and describe the complexity of nutritional care. Aim: By using the FoC framework as an analytic framework, this study explores how the nurse-patient relationship shapes the nutritional care of orthopaedic patients. Method:This study is a secondary analysis using deductive content analysis of interviews with patients undergoing major orthopaedic surgery, nursing staff and observations of interactions between nursing staff and patients. The core dimension of the FoC framework, 'Establishment of relationship,' was used as an analytic framework. Result:The nurses perceived serving meals and providing nutritional supplements as an essential part of the nutritional care. Still, the nutritional care was organised as a routine task to be less time-consuming. Appropriate care was initiated when the nursing staff explored patients´ food preferences. When the nursing staff failed to familiarise themselves with the patient's preferences, the patients interpreted nutritional care as unrelated to their needs, resulting in a lack of trust. Conclusion:The need for efficiency within nutritional care must not compromise the patients' need for dialogue with the nurse. Establishing a trusting relationship between nurses and patients prevents nutritional care from becoming a routine task unrelated to the patients' needs.

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Section: Discussionmentioning

confidence: 80%

Dialogue is a prerequisite for the nurse–patient relationship in nutritional care: A secondary analysis using the fundamentals of care framework

Jensen

Nørholm

Poulsen

et al. 2022

Scandinavian Caring Sciences

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“…As reported in Kalisch's studies, weaknesses in effective communication with medical staff are often a dimension of MNC ( 16 ). When nurses could not communicate and focused exclusively on tasks such as medication, patients remained unrelated to basic care needs ( 39 ). In studies by Marsh et al, nurses reported most missed care in the communication and preparation categories ( 40 ).…”

Section: Discussionmentioning

confidence: 99%

Causes of Missed Nursing Care During COVID-19 Pandemic: A Qualitative Study in Iran

Safdari

Rassouli

Jafarizadeh

et al. 2022

Front. Public Health

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BackgroundThe unpredictable and variable nature of COVID-19 and the lack of healthcare resources has led to inadequate care for patients. This study aimed to explain the causes of missed nursing care during the COVID-19 pandemic from the perspective of Iranian nurses.MethodThis qualitative study was conducted using semi-structured interviews with 14 nurses caring for patients with COVID-19 in three hospitals in Iran. Sampling was performed by the purposive method. Data were analyzed using the conventional content analysis method. The interviews were first recorded and transcribed, and then the data were analyzed using the Elo and Kyngas method. Data management was done with MAXQDA software version 10. To achieve trustworthiness, the criteria presented by Lincoln and Guba were used.FindingsA total of 14 nurses participated in the study. The mean age of participants was 31.85 ± 4.95 years, and the mean number of years of work experience was 7.71 ± 4.44. Eleven participants were women. Among all participants, nine had a bachelor's degree and five had a master's degree. Four nurses had fixed shifts, while ten nurses had rotating shifts. The causes of missed nursing care were categorized into 4 groups. The category “unfulfilled care” comprised the reasons for forgetting care, neglecting care, arbitrary elimination of care, and compulsory elimination of care. The category of “care at improper time” consisted of interference of the care in patients' daily activities and interference with other healthcare providers' activities. The “incomplete cares” category comprised failure to complete the care period in hospital, interruption in care, and discontinuance of care after patient discharge. The last category, “incorrect care,” consisted of providing care regardless of the nursing process, providing care by unqualified professionals, and providing trial-and-error care.ConclusionThis study illustrates an understanding of the causes of missed nursing care during the COVID-19 pandemic from the perspective of nurses. The increasing demand for care caused by the pandemic and problems in the work environment has led to the failure of nurses to provide complete, correct care and sometimes miss parts of care to patients. Therefore, nursing policymakers and managers should develop and implement appropriate care protocols and instructions to minimize missed nursing care.

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“…Along this line, to our best knowledge, this is the first study attempting to analyse the convergences, if any, between The Framework and UNC tools. These lines of research seem to have been developed independently from each other, and only sparse traces have considered them potentially linkable; visible examples can be found in some studies, as for example, (a) ‘addressing fundamental care has been highlighted internationally as a response to missed nursing care’ (Muntlin Athlin, 2018, p. 2230), and (b) ‘missed nursing care causes severe consequences for patients… and person‐centred fundamental care in which communication is central provide an approach to manage this challenge’ (Avallin et al, 2020, p. 1). Other attempts have been performed to align The Framework with other concepts (e.g.…”

Section: Discussionmentioning

confidence: 99%

“…Alongside their different aims and orientations, there is a potential area of synergy between these research lines on the fundamentals of care conceptually defined by The Framework (Kitson et al, 2013) and the measures extensively developed by UNC researchers (Palese et al, 2020). Avoiding unfinished care might mean addressing and facilitating the patients' fundamental care needs (Avallin et al, 2020). However, to our best knowledge, no concrete attempts have been undertaken to date to establish whether, and to what extent, instruments measuring UNC have the ability to represent the fundamental care needs included in The Framework.…”

Section: Introductionmentioning

confidence: 99%

To what extent Unfinished Nursing Care tools coincide with the discrete elements of The Fundamentals of Care Framework? A comparative analysis based on a systematic review

Palese

Longhini

Danielis

2020

Journal of Clinical Nursing

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Aims and objectives To establish whether, and to what extent, tools measuring Unfinished Nursing Care (UNC) that have been validated to date have the ability to detect the discrete elements of the ‘Integration of care’ dimension of The Fundamentals of Care Framework (The Framework). Background UNC and The Framework have been established as two separate research lines, focused on (a) omitted care and related tools, and (b) on how to improve patient care, respectively. However, no attempts have been made to date to establish whether, and to what extent, tools measuring UNC have the ability to represent the discrete elements of The Framework. Design A two‐step study: (a) a secondary analysis of a systematic review up to June 2018 later updated in May 2020, followed by (b) a comparative analysis. Methods A systematic review of studies on validated tools measuring UNC was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline. Then, researchers independently performed a comparative analysis between the extracted (a) discrete elements of The Framework and (b) items of the UNC tools retrieved. Results A total of 14 tools were analysed. The physical dimension of The Framework was the one mostly covered by UNC tools (up to 87.5% with the Perceived Implicit Rationing of Nursing Care). The Norwegian Basel Extent of Rationing of Nursing Care showed the highest level of representation (41.6%) for the psychosocial dimension. Only the Perceived Implicit Rationing of Nursing Care and the Unfinished Care tool measure the relational dimension (22.2%, respectively). By considering all elements of the ‘Integration of care’ dimension, the Perceived Implicit Rationing of Care had the highest percentage of convergence (41%). Conclusion Not all UNC tools have the same ability to represent the discrete elements of The Framework. Moreover, physical needs are more often detected in UNC tools compared to the relational and psychological ones. Relevance to clinical practice Unfinished care tools validated to date can represent a body of knowledge on which to build The Framework metrics, especially for the physical dimensions.

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Using communication to manage missed care: A case study applying the Fundamentals of Care framework

Cited by 34 publications

References 28 publications

Dialogue is a prerequisite for the nurse–patient relationship in nutritional care: A secondary analysis using the fundamentals of care framework

Dialogue is a prerequisite for the nurse–patient relationship in nutritional care: A secondary analysis using the fundamentals of care framework

Causes of Missed Nursing Care During COVID-19 Pandemic: A Qualitative Study in Iran

To what extent Unfinished Nursing Care tools coincide with the discrete elements of The Fundamentals of Care Framework? A comparative analysis based on a systematic review

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