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Purpose Nonventilator hospital‐acquired pneumonia (NV‐HAP) is an underreported and unstudied disease, with potential for measurable outcomes, fiscal savings, and improvement in quality of life. The purpose of our study was to (a) identify the incidence of NV‐HAP in a convenience sample of U.S. hospitals and (b) determine the effectiveness of reliably delivered basic oral nursing care in reducing NV‐HAP. Design A descriptive, quasi‐experimental study using retrospective comparative outcomes to determine (a) the incidence of NV‐HAP and (b) the effectiveness of enhanced basic oral nursing care versus usual care to prevent NV‐HAP after introduction of a basic oral nursing care initiative. Methods We used the International Statistical Classification of Diseases and Related Problems (ICD‐9) codes for pneumonia not present on admission and verified NV‐HAP diagnosis using the U.S. Centers for Disease Control and Prevention diagnostic criteria. We completed an evidence‐based gap analysis and designed a site‐specific oral care initiative designed to reduce NV‐HAP. The intervention process was guided by the Influencer Model™ (see Figure ) and participatory action research. Findings We found a substantial amount of unreported NV‐HAP. After we initiated our oral care protocols, the rate of NV‐HAP per 100 patient days decreased from 0.49 to 0.3 (38.8%). The overall number of cases of NV‐HAP was reduced by 37% during the 12‐month intervention period. The avoidance of NV‐HAP cases resulted in an estimated 8 lives saved,$1.72 million cost avoided, and 500 extra hospital days averted. The extra cost for therapeutic oral care equipment was $ 117,600 during the 12‐month intervention period. Cost savings resulting from avoided NV‐HAP was$1.72 million. Return on investment for the organization was $ 1.6 million in avoided costs. Conclusions NV‐HAP should be elevated to the same level of concern, attention, and effort as prevention of ventilator‐associated pneumonia in hospitals. Clinical Relevance Nursing needs to lead the way in the design and implementation of policies that allow for adequate time, proper oral care supplies, ease of access to supplies, clear procedures, and outcome monitoring ensuring that patients are protected from NV‐HAP.

Fundamental care has come under increased scrutiny due to high-profile reports globally of poor nursing care. The reasons for these documented care failures are widely debated, with some scholars identifying issues with how fundamental care is valued within healthcare systems and by nurses. During focus groups designed to evaluate a fundamental care education intervention, we identified a perception commonly held by first-year pre-registration (pre-licensure) students that appeared indicative of a de-valuing of fundamental care: students routinely described fundamental care as ‘common sense’ and doubted that such care should form a key part of their education. In this paper, we explore this perception and its potential consequences for nursing education, clinical practice, and research. We argue that a perception of fundamental care as ‘common sense’ is a myth; it undermines the inherent complexity of providing such care to a consistently high standard and has negative implications for nursing education and continuing professional development, patient experiences and outcomes, and the advancement of nursing science. It is a perception that must be challenged.

International evidence suggests nursing is not providing fundamental care consistently or adequately, resulting in poor outcomes for patients and healthcare systems. One possible reason for this inadequate care delivery is nursing education, with fundamental care often implicit or invisible in nursing curricula. To understand how best to teach fundamental care to pre-registration (pre-licensure) students, we developed and piloted a six-week intervention that incorporated into the first-year curriculum a more explicit focus on fundamental care. A conceptual fundamental care framework was used to guide students' learning, and clinical skills sessions were structured to reinforce the framework's conceptual understanding and enable students to practice delivering fundamental care in an integrated manner. The intervention's impact was explored via a pre-post survey and focus groups. The survey demonstrated that the intervention did not affect students' ability to identify patients' fundamental care needs; however, focus groups showed the intervention assisted students in understanding the complexity of fundamental care and its importance to patients' experiences. The pilot provides preliminary evidence on the importance of embedding fundamental care into nursing curricula early and explicitly, and emphasising the integrated nature of such care, particularly through structured debriefs, consistent terminology, and opportunities for students to experience care as a patient. •Fundamental care is often inadequately taught to pre-registration nursing students.•A pilot educational intervention was implemented at an Australian University.•The pilot incorporated into the curriculum a more explicit focus on fundamental care.•Experiencing being the ‘patient’ was crucial for student learning.•A challenge remains how to measure the impact of such educational interventions.

Background Most patients in specialized palliative care units need nursing support to perform activities of daily living (ADL), such as using a toilet or transferring out of a bed or chair. To deliver high-quality ADL support that facilitates patients’ movement and protects nurses’ musculoskeletal health, nurses need appropriate knowledge and skills. The objective of this study is to investigate the impact of education based on the “Advanced Kinaesthetics in Palliative care (AdKinPal) program” on the competence in Kinaesthetics, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints of nurses from specialist palliative care units. Methods A pretest–posttest repeated measures design was applied. The study took place in three specialised units for palliative care in Switzerland between June 2018 and April 2020. All the nurses who worked in participating wards (n = 62) and fulfilled the inclusion criteria were asked to participate. The intervention – the AdKinPal program – is an education-based training program conducted for six months. We took measurements using self-administered questionnaires at three points before and after the intervention. Using descriptive statistics, repeated measurement analysis of variance (ANOVA) and independent-samples t-tests, we analysed the participants’ demographic characteristics as well as developments over time and relationships between the three outcome variables: Kinaesthetics competence, self-efficacy regarding ADL support in end-of-life care and musculoskeletal complaints. Results Fifty-nine nurses and one physiotherapist participated, and 38 participants (63%) responded to all three questionnaires. The AdKinPal training improved the nurses’ perceived Kinaesthetics competence and self-efficacy regarding ADL support in end-of-life care. Participants who reported lower back, neck or shoulder pain had a significantly lower Kinaesthetics competence. Conclusions The AdKinPal program can raise nurses’ Kinaesthetics competence. Thereby, patients’ autonomy and quality of life could be supported, and symptom management could be enhanced in a holistic manner. Furthermore, the AdKinPal program fosters nurses’ self-efficacy in ADL support in end-of-life care. A strong sense of self-efficacy enhances professional well-being in many ways. Additionally, the nursing staff’s musculoskeletal health can be promoted by enhancing their Kinaesthetics competence. Trial registration DRKS00015908. Registration Date 23.11.2018.

The Nursing profession is struggling to return to basic nursing care to maintain patients’ safety. “Interventional patient hygiene” (IPH) is a measurement model for reducing the bioburden of both the patient and health care worker, and its components are hand hygiene, oral care, skin care/antisepsis, and catheter site care. To identify the level of nurses’ practice and knowledge about interventional patient hygiene and identify barriers for implementing interventional patient hygiene in critical care units. A descriptive research design was used and three tools were applied in this study: “The Interventional Patient Hygiene Observational Checklist”, “The Interventional Patient Hygiene Knowledge Questionnaire” and “The Barriers for Implementing Interventional Patient Hygiene in Critical Care Units”. The mean percentage nurses’ knowledge score is higher than the mean percentage practice score in all items (hand hygiene (71.28±25.46, compared with 46.15±17.87), oral care (100.0±0.0, compared with 25.32±24.25), catheter care (75.76±9.40, compared with 8.97±24.14) and skin care (47.80±6.79, compared with 26.28±16.57). Barriers for implementing hand hygiene are workload (71.79%), insufficient resources (61.53%), and lack of knowledge (10.25%). The mean percentage IPH knowledge score is higher than the mean percentage IPH practice score of all IPH items. Barriers for implementing IPH include workload, insufficient resources, and lack of knowledge/training.

Research in nursing education demonstrates that the fundamentals of care are paid less attention in this field resulting in negative consequences for students' learning outcomes. The aim of this qualitative study was to explore nursing students' perceptions towards being taught the fundamentals of care by clinical nurses within a simulated learning environment. The study has a qualitative explorative design. Data was collected through participant observation and focus group interviews and analysed using qualitative content analysis. The analysis revealed two main categories indicating how the students gained knowledge in the research setting: ‘Getting the best of both worlds’, and ‘Having it in many ways’. The findings are discussed against Vygotsky's theory of cognitive development suggesting that the students were content with being taught the fundamentals of care by clinical nurses within an simulated learning environment.

Background:The alignment of the clinical placements of students to a range of clinical sites that responds to the primary health care agenda is part of the prescripts of the nursing program. The relevancy of old age homes that are serving the aged community has been a concerning omission by nursing education institutions.Aim:This paper aims to establish if old age homes have learning opportunities and the infrastructure for basic nursing care linked to the primary health care agenda for nursing students.Setting:The study was conducted at a private nursing education institution in Tshwane, South Africa.Methodsv/*-:A quantitative descriptive research design was employed in this study. Descriptive statistics was used by a senior statistician to analyse6+3Sxc vb the themes and sub-categories. An intensive literature review was integrated into the analysis of data.Results:A total of thirty-one second-year nursing students participated voluntarily in the study; they completed the closed-ended and open-ended questionnaires. Eighty-one percent agreed that old age homes have clinical learning opportunities in line with their first-level outcomes; however, they do not have the support and the infrastructure.Conclusions:Analysing the findings, the conclusions can be drawn that nurse educators have not identified old age homes as clinical sites and that there are limitations that impact on the competency of students and the provision of basic nursing care to respond to the primary health care agenda.Contribution:The results of this study contribute to the body of knowledge for nurse educators, old age homes, and policymakers

Purpose This study aimed to evaluate the frequency of psychosocial aspects of basic nursing care, as e‐charted by nurses, when using an interface terminology. Methods An observational, multicentre study was conducted in acute wards. The main outcome measure was the frequency of use of the psychosocial interventions in the electronic nursing care plans, analysed over a 12 month retrospective review. Findings Overall, 150,494 electronic care plans were studied. Most of the intervention concepts from the interface terminology were used by registered nurses to illustrate the psychosocial aspects of fundamentals of care in the electronic care plans. Conclusions and Implications The results presented help to demonstrate that the interventions of this interface terminology may be useful to inform psychosocial aspects of basic and advanced nursing care. Clinical relevance The identification of psychosocial elements of basic nursing care in the nursing documentation may lead to obtain a deeper understanding of those caring interventions nurses consider essential to represent nurse‐patient interactions. The frequency of psychosocial interventions may contribute to delineate basic and advanced nursing care.

Purpose To develop a definition of basic nursing care for the hospitalized adult patient and drive uptake of that definition through the implementation of an electronic health record. Design and Methods A team of direct care nurses, assisted by subject matter experts, analyzed nursing theory and regulatory requirements related to basic nursing care. The resulting list of activities was coded using the Clinical Care Classification (CCC) system and incorporated into the electronic health record system of a 170‐bed community hospital. Results Nine basic nursing care activities were identified as a result of analyzing nursing theory and regulatory requirements in the framework of a hypothetical “well” patient. One additional basic nursing care activity was identified following the pilot implementation in the electronic health record. The pilot hospital has successfully passed a post‐implementation regulatory review with no recommendations related to the documentation of basic patient care. Conclusions This project demonstrated that it is possible to define the concept of basic nursing care and to distinguish it from the interdisciplinary, problem‐focused plan of care. The use of the electronic health record can help clarify, document, and communicate basic care elements and improve uptake among nurses. Clinical Relevance This project to define basic nursing care activities and incorporate into the electronic health record represents a first step in capturing meaningful data elements. When fully implemented, these data could be translated into knowledge for improving care outcomes and collaborative processes.

Research demonstrates that basic nursing care receives less attention in clinical settings and has become visually less prominent in nursing education curriculums. While much is known about the importance of preceptorship in clinical settings, little is known about how preceptors teach basic nursing care to students in a school simulation lab. This study explores the preceptors’ perceptions of teaching basic nursing care to nursing students in the school simulation lab compared to clinical settings. Data were collected through focus group interviews and participant observation and analyzed by using qualitative content analysis. Three main categories emerged: (i) Perceived advantages and disadvantages, (ii) Positive attitudes – remembering being a student, and (iii) Knowing what to do and showing how to do it. Awareness of the importance of having knowledge about basic nursing care may contribute to counterbalancing the devaluation of basic nursing care among nursing students.