Aim The aims of this literature review were to better understand the current literature about person-centred care (PCC) and identify a clear definition of the term PCC relevant to nursing practice. Method/Data sources An integrative literature review was undertaken using The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Scopus and Pubmed databases. The limitations were English language, full text articles published between 1998 and 2018 within Australian, New Zealand, Canada, USA, Europe, Ireland and UK were included. The international context off PCC is then specifically related to the Australian context. Review methods The review adopted a thematic analysis to categorise and summarise themes with reference to the concept of PCC. The review process also adhered to the Preferred Reporting System for Meta-Analysis (PRISMA) and applied the Critical Appraisal Skills Programme (CASP) tools to ensure the quality of the papers included for deeper analysis. Results While definitions of PCC do exist, there is no universally used definition within the nursing profession. This review has found three core themes which contribute to how PCC is understood and practiced, these are People, Practice and Power. This review uncovered a malalignment between the concept of PCC and the operationalisation of the term; this misalignment was discovered at both the practice level, and at the micro, meso and micro levels of the healthcare service. Conclusion The concept of PCC is well known to nurses, yet ill-defined and operationalised into practice. PCC is potentially hindered by its apparent rhetorical nature, and further investigation of how PCC is valued and operationalised through its measurement and reported outcomes is needed. Investigation of the literature found many definitions of PCC, but no one universally accepted and used definition. Subsequently, PCC remains conceptional in nature, leading to disparity between how it is interpreted and operationalised within the healthcare system and within nursing services.

/pdf/whose-centre-is-it-anyway-defining-person-centred-care-in-1y8rxfzike.pdf

Whose centre is it anyway? Defining person-centred care in nursing: An integrative review

Background Rationing of care in nursing is nurses' inability to complete all care activities for patients because of scarcity in time and resource. Literature suggests that rationing of care is closely related to patient safety and quality of care. The phenomena have been defined and studied from varied perspectives and contexts. A systematic review of studies related to the concept was aimed at identifying and synthesizing the finding. Methods The review followed Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines, and literature searches were conducted in MEDLINE, CINAHL, PsycInfo, Web of Science and EMBASE databases. Fifty-seven quantitative studies were included in the review. Findings The review observed that nursing activities addressing the emotional, educational, mobility and hygiene needs of the patients were commonly rationed. Antecedents of rationing included resource inadequacy and organizational work environment. Rationing influenced patient satisfaction, mortality and a number of adverse events and was associated with decreased job satisfaction, increased intention to leave and high turnover among nurses. Discussions This review concludes that rationing in nursing is ubiquitous, embedded in the work environment and poses a threat to the professional health and philosophical base of nursing in addition to having serious implications on patients' safety. Strategies to reframe and reconsider organizational traits, and open discussion with other healthcare stakeholders can reduce rationing of nursing care. The review suggests future researchers adopt different methodological layout to study rationing.

Rationing of nursing care, a deviation from holistic nursing: A systematic review.

Aim:

The aim of this study was to understand the beliefs, attitudes and perceptions of nurses regarding family participation and collaboration in the care of their hospitalized adult relative.

Background:

Family participation in care is known to enhance the quality of patient care. Nurses are uniquely placed to support such participation, including the delivery of fundamental care. However, nurses’ attitudes and beliefs may help or hinder participation.

Design:

A mixed methods approach with an exploratory sequential design was used.

Setting:

A regional referral hospital in Australia.

Participants:

Nurses were eligible to participate in the study if they were permanent staff of the hospital, and who in their day-to-day work had direct contact with adult patients and their families on acute care wards.

Methods:

Observer-as-participant observation data and semi-structured interviews were undertaken. 30 hours of observational data were gathered, and 14 nurses were interviewed. Data collection occurred between September and December 2016. Following separate analysis, data were triangulated.

Results:

Analysis uncovered two contrasting categories: (1) enacting family participation (four themes); and (2) hindering family participation (five themes).

Conclusion:

The findings of our study demonstrated that the practices of nurses do not always align with healthcare policies, and strategies to support nurses to enact patient and family centered practices are needed. Relevance to clinical practice: Nurses can use these findings to make informed evidence based changes to the way they practice and communicate with families to ensure fundamental care is delivered.

/pdf/acute-care-nurses-views-on-family-participation-and-2936kxt77r.pdf

Acute care nurses' views on family participation and collaboration in fundamental care.

Striking a balance: Health care providers’ experiences with home-based, patient-centered care for older people—A meta-synthesis of qualitative studies

Mandated face mask use for health care providers, secondary to COVID-19, creates an additional communication barrier for older adults with cognitive, communication, and/or hearing challenges. Face masks can soften a speaker's voice, conceal vocal tone, and hide facial expressions that relay essential non-verbal information. An inability to understand health care information or words of support can lead to frustration, anxiety, and decreased quality of life. Therefore, the purpose of this article is to review the current research, provide clinical examples, and highlight communication strategies, supports (i.e., written, gestural, and picture supports), and modifications to personal protective equipment that health care providers can implement, in isolation or combined, to improve communication with older adults. [Journal of Gerontological Nursing, 46(11), 7-11.].

Optimizing Effective Communication While Wearing a Mask During the COVID-19 Pandemic.

https://www.collegianjournal.com/article/S1322-7696(17)30039-2/pdf

The tension between person centred and task focused care in an acute surgical setting: A critical ethnography

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The tension between person centred and task focused care in an acute surgical setting: A critical ethnography