Orchestrating care through the fast-track perspective: A qualitative content analysis of the provision of individualised nursing care in orthopaedic fast-track programmes
详细信息 查看全文
- 作者：Connie Bø ; ttcher Berthelsen ; RN ; MScN ; PhD ; cb@ph.au.dk (Assistant Professor) ; Kirsten Frederiksen ; RN ; MEd ; PhD (Associate Professor ; Study Director)
- 关键词：Orthopaedic ; Fast-track programme ; Total hip and knee replacement ; Nursing ; Content analysis ; Older patients ; Qualitative ; Individual care
- 刊名：International Journal of Orthopaedic and Trauma Nursing
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：24
- 期：Complete
- 页码：40-49
- 全文大小：323 K
- 卷排序：24
文摘
The lack of individualised care in orthopaedic regimes is often explained by the extended use of patient pathways and clinical guidelines. The aim of this study was to illuminate orthopaedic nurses' perceptions and experiences of providing individual nursing care for older patients in standardised fast-track programmes after total hip or knee replacement. Ten semi-structured interviews were conducted with orthopaedic nurses in orthopaedic wards at three Danish hospitals between April and June of 2015. Data were analysed using manifest and latent content analysis according to Graneheim and Lundman. The main theme of the overall interpretation was Orchestrating care through the fast-track perspective, accompanied by three sub-themes: Identifying and legitimising relevant individual care in the fast-track programme, Struggling to fit all patients in the fast-track programme and Justifying individualised care-related actions in the fast-track programme. The study concluded that, even though the nurses struggled to comply with the programme, they still found themselves compromising their nursing care and ethics to follow the standardised regime. There is a need to establish more specific inclusion criteria to maintain the effective elements in the programme and to facilitate nurses' opportunities to offer individual care, thereby ensuring that fragile patients have access to other possibilities.