'Stolen Time'-Delivering Nursing at the Bottom of a Hierarchy : An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia
Eekholm, Signe LU ; Samuelson, Karin LU ; Ahlström, Gerd LU
and Lindhardt, Tove
LU
(2021)
In Healthcare
9(11).
- Abstract
The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses' (RNs') adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ''stolen time'-delivering nursing at the bottom of a hierarchy', and three themes: (1) 'under... (More)
The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses' (RNs') adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ''stolen time'-delivering nursing at the bottom of a hierarchy', and three themes: (1) 'under the dominance of stronger paradigms', (2) 'the loss of professional identity', and (3) 'the power of leadership'. These themes, each comprising two to three subthemes, illustrated that RNs' adherence to EBG recommendations was strongly influenced by the individual RN's professionalism and professional identity; contextual barriers, including the interdisciplinary team, organisational structure, culture, and evaluation of the NC; and the nurse manager's leadership skills. This study identified central factors that may help RNs to understand the underlying dynamics in a healthcare setting hindering and facilitating the performance of NC and make them better equipped for changing practices.
(Less)
- author
- Eekholm, Signe
LU
; Samuelson, Karin
LU
; Ahlström, Gerd
LU
and Lindhardt, Tove
LU
- organization
- publishing date
- 2021-11-09
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Evidence-based practice, Fundamental care, Nurse manager, nursing care, nursing practice, organisational behaviour;, patient safety, work organisation
- in
- Healthcare
- volume
- 9
- issue
- 11
- article number
- 1524
- publisher
- MDPI AG
- external identifiers
-
- pmid:34828571
- scopus:85119136587
- ISSN
- 2227-9032
- DOI
- 10.3390/healthcare9111524
- language
- English
- LU publication?
- yes
- id
- f125bc5e-6af0-4e5e-a5b6-ff40c211e03e
- date added to LUP
- 2021-12-02 14:07:49
- date last changed
- 2024-06-15 21:55:05
@article{f125bc5e-6af0-4e5e-a5b6-ff40c211e03e,
abstract = {{<p>The research has reported a high prevalence of low-quality and missed care for patients with community-acquired pneumonia (CAP). Optimised nursing treatment and care will benefit CAP patients. The aim of this study was to describe the barriers and facilitators influencing registered nurses' (RNs') adherence to evidence-based guideline (EBG) recommendations for nursing care (NC) for older patients admitted with CAP. Semi-structured focus group interviews (n = 2), field observations (n = 14), and individual follow-up interviews (n = 10) were conducted in three medical units and analysed by a qualitative content analysis. We found a main theme: ''stolen time'-delivering nursing at the bottom of a hierarchy', and three themes: (1) 'under the dominance of stronger paradigms', (2) 'the loss of professional identity', and (3) 'the power of leadership'. These themes, each comprising two to three subthemes, illustrated that RNs' adherence to EBG recommendations was strongly influenced by the individual RN's professionalism and professional identity; contextual barriers, including the interdisciplinary team, organisational structure, culture, and evaluation of the NC; and the nurse manager's leadership skills. This study identified central factors that may help RNs to understand the underlying dynamics in a healthcare setting hindering and facilitating the performance of NC and make them better equipped for changing practices.</p>}},
author = {{Eekholm, Signe and Samuelson, Karin and Ahlström, Gerd and Lindhardt, Tove}},
issn = {{2227-9032}},
keywords = {{Evidence-based practice; Fundamental care; Nurse manager; nursing care; nursing practice; organisational behaviour;; patient safety; work organisation}},
language = {{eng}},
month = {{11}},
number = {{11}},
publisher = {{MDPI AG}},
series = {{Healthcare}},
title = {{'Stolen Time'-Delivering Nursing at the Bottom of a Hierarchy : An Ethnographic Study of Barriers and Facilitators for Evidence-Based Nursing for Patients with Community-Acquired Pneumonia}},
url = {{http://dx.doi.org/10.3390/healthcare9111524}},
doi = {{10.3390/healthcare9111524}},
volume = {{9}},
year = {{2021}},
}