As a profession, nursing purports to embrace evidence‐based practice, and nurses of all levels are urged to access and utilise evidence in planning and delivering care for their patients. We do this on the assumption that the evidence is out there, and it is simply a matter of nurses finding the evidence and using it when developing guidance for practice, in policy and at point the of care delivery (Jackson & Kozlowska, 2018). In reality, however, many key areas of nursing practice suffer because we have failed to provide rigorous evidence to support it.
Methods:
A systematic review by Richards, Hills, Pentecost, Goodwin and Frost (2018) suggests the existing evidence for fundamental care interventions is miserably inadequate and highlights the crucial “lack of evidence of effectiveness for interventions in core areas such as elimination, nutrition, mobility and hygiene” (Richards et al., 2018). To date we have failed to provide the necessary evidence to support many aspects of fundamental care, including how such care is best delivered, when and by whom.
Results:
There is increasing interest and aspiration to develop the evidence base for the fundamentals of care within the nursing community (Kitson, 2018). The challenge for researchers remains to either focus on one fundamental (for example, hydration or dignity), or to try to explore the overall cumulative impact of fundamental care which integrates the patient’s physical, relational and psychosocial needs. Previous research has illustrated the difficulty in separating the physical impact from psychosocial and relational elements of nursing interventions related to the fundamentals of care (Kitson, Dow, Calabrese, Locock, & Athlin, 2013; Kitson & Muntlin Athlin, 2013). An integrated picture of care reflects the reality of nursing practice and rigorous research is urgently needed to understand this reality and develop effective interventions for fundamental care.
The first step towards developing a robust evidence base is to ensure there is a common understanding of and definition for fundamental care. We need an agreed definitive theoretical basis for the teaching, delivery, evaluation and exploration of the fundamental of care. We need also to expand our vision to encompass the delivery of fundamental care beyond the hospital setting and across all care trajectories.
Conclusion:
This presentation will explore the development and refinement of a theoretical model for fundamental care delivery.