Despite the growing importance of nursing fundamentals of care, nurses often overlook these aspects of care. In this study, we explored why this happens precisely where nursing education is initially provided. In fact, little is known about how undergraduate nursing students perceive the teaching of fundamentals of care and how they value them.
This pilot cross-sectional study used a questionnaire adapted and validated in Italian to assess the perceptions of first, second, and third-year undergraduate nursing students (n=150) in an Italian university about the teaching of fundamentals of care during theoretical lessons and clinical practice.
In the first section of the tool, on general fundamentals of care, students reported high levels of agreement for all items (range between 61.2% -100%).
In the section on nutrition, divided into nutrition, oral intake of fluids, and malnutrition high percentages of agreement (50-100%) were obtained, but for questions regarding ‘learning how to document food and fluid intake’, first-year students reported low levels of agreement.
With regard to the ‘Communication Section’, the item about ‘learning how to inform minor patients’ presented low percentages of agreement throughout the three-year program. Of the first-year students, between 71.4%-77.6% declared they had not received instructions about this.
Understanding how nursing students perceive the importance of learning of fundamentals of care during their curriculum and how their multidimensional nature is highlighted by teachers and clinical supervisors, will enable educators to address the gaps in the way they taught and prioritized within the curriculum.
1. Kitson A, Conroy T, Wengstrom Y, Profetto-McGrath J, Robertson-Malt, S. Defining the fundamentals of care. Int J Nurs Pract 2010; 16(4): 423-434. doi: 10.1111/j.1440-172X.2010.01861.x
2. Feo R, Conroy T, Jangland E, Muntlin Athlin Å, Brovall M, Parr J, Blomberg K, Kitson A. Towards a standardised definition for fundamental care: A modified Delphi study. J Clin Nurs 2018; 27(11-12): 2285-2299. doi:10.1111/jocn.14247
3. International Learning Collaborative, 2020. The Fundamentals of Care. available at: https://intlearningcollab.org/mission/the-fundamentals-of-care/ (accessed 5 July 2020)
4. Feo R, Conroy T, Marshall RJ, Rasmussen P, Wiechula R, Kitson A. Using holistic interpretive synthesis to create practice-relevant guidance for person-centred fundamental care delivered by nurses. Nurs Inq 2017; 24(2): e12152. doi:10.1111/nin.12152
5. Kitson A, Marshall A, Bassett K, Zeitz K. What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. J Adv Nurs 2013; 69(1): 4-15. doi:10.1111/j.1365-2648.2012.06064.x
6. Heaven B, Bamford C, May C, Moynihan P. Food work and feeding assistance on hospital wards. Sociol Health Ill 2013; 35(4): 628-642. doi:10.1111/j.1467-9566.2012.01515.x
7. Bagnasco A, Dasso N, Rossi S, Galanti C, Varone G, Catania G, Zanini M, Aleo G, Watson R, Hayter M, Sasso L. Unmet Nursing Care Needs On Medical And Surgical Wards: A Scoping Review Of Patients’ Perspectives. J Clin Nurs 2020; 29(3-4), 347-369. Doi: 10.1111/jocn.15089
8. Kitson A. The fundamentals of care framework as a point-of-care nursing theory. Nurs Res 2018; 67(2): 99-107. doi:10.1097/NNR.0000000000000271
9. Papastavrou E, Andreou P, Tsangari H, Merkouris A. Linking patient satisfaction with nursing care: The case of care rationing - a correlational study. BMC Nurs 2014; 13(1): 1-10. doi:10.1186/1472-6955-13-26
10. Feo R, Donnelly F, Frensham L, Conroy T, Kitson A. Embedding fundamental care in the pre-registration nursing curriculum: Results from a pilot study. Nurse Educ Pract 2018; 31: 20–28. doi:10.1016/j.nepr.2018.04.008
11. Huisman-de Waal G, Feo R, Vermeulen H, Heinen M. Students’ perspectives on basic nursing care education. J Clin Nurs 2018; 27(11-12): 2450-2459. doi:10.1111/jocn.14278
12. MacMillan K. The Hidden Curriculum: What Are We Actually Teaching about the Fundamentals of Care? Nurs Leadership 2016; 29(1): 37-46. doi:10.12927/cjnl.2016.24644
13. Francis R. Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationary Office; 2013.
14. Zwakhalen SMG, Hamers JPH, Metzelthin SF, Ettema R, Heinen M, de Man-Van Ginkel JM, Vermeulen H, Huisman-de Waal G, Schuurmans MJ. Basic nursing care: The most provided, the least evidence based – A discussion paper. J Clin Nurs 2018; 27(11-12): 2496-2505. doi:10.1111/jocn.14296
15. Bagnasco A, Timmins F, de Vries J, Aleo G, Zanini M, Catania G, Sasso L. Understanding and addressing missed care in clinical placements - Implications for nursing students and nurse educators. Nurse Educ Today 2017; 56: 1–5. Doi: 10.1016/j.nedt.2017.05.015
16. Polit DF, Beck CT. Generalization in quantitative and qualitative research: Myths and strategies. Int J Nurs Stud 2010; 47(11): 1451-1458. doi: 10.1016/j.ijnurstu.2010.06.004
17. Aaberg V. The state of sexuality education in baccalaureate nursing programs. Nurse Educ Today 2016; 44: 14–19. doi:10.1016/j.nedt.2016.05.009
18. White BP, Abuelezam NA, Dwyer AA, Fontenot HB. A sexual health course for advanced practice registered nurses: Effect on preparedness, comfort, and confidence in delivering comprehensive care. Nurse Educ Today 2020; 92: 104506. Advance online publication. doi:10.1016/j.nedt.2020.104506
19. Bagnasco A, Pagnucci N, Tolotti A, Rosa F, Torre G, Sasso L. The role of simulation in developing communication and gestural skills in medical student. BMC Med Educ 2014; 14(1): 1-7. doi: 10.1186/1472-6920-14-106
20. Woodward S. Implementing patient safety. New York: Taylor and Francis CRC Press; 2019.
21. World Health Organization. Patient Safety Curriculum Guide: Multi-professional Edition; 2013. http://whqlibdoc.who.int/publications/ 2011/9789241501958_eng.pdf (accessed 5 July 2020)
22. NHS England, 2017. Patient safety. https://www.england.nhs.uk/five-year-forward- view/next-steps-on-the-nhs-five-year-forward-view/patient-safety/. (accessed 5 July 2020)
23. Cresswell K, Howe A, Steven A, Smith P, Ashcroft D, Fairhurst K, Bradley F, Magnusson C, McArthur M, Pearson P, Sheikh A. Patient Safety Education Research Group. Patient safety in healthcare preregistration educational curricula: multiple case study-based investigations of eight medicine, nursing, pharmacy and physiotherapy university courses. BMJ Qual Saf 2013; 22(10): 843-854. doi: 10.1136/bmjqs-2013-001905.
24. Dimoula M, Kotronoulas G, Katsaragakis S, Christou M, Sgourou S, Patiraki E. Undergraduate nursing students' knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey. Nurse Educ Today 2019; 74: 7–14. doi:10.1016/j.nedt.2018.11.025
25. Chan ZC. A qualitative study on communication between nursing students and the family members of patients. Nurse Educ Today 2017; 59: 33-37. doi:10.1016/j.nedt.2017.08.017
26. Adib-Hajbaghery M. Faraji M. Comparison of effect between group discussion and educational booklet on Iranian nursing students' attitude and practice toward patient privacy. J Educ Eval Health Prof 2016; 13: 29. doi: 10.3352/jeehp.2016.13.29
27. Papastavrou E, Efstathiou G, Andreou C. Nursing students' perceptions of patient dignity. Nurs Ethics 2016; 23(1): 92–103. doi:10.1177/0969733014
28. Corsello G, Ferrara P, Chiamenti G, Nigri L, Campanozzi A, Pettoello-Mantovani M. The Child Health Care System in Italy. J Pediatr 2016; 177S: S116–S126. doi:10.1016/j.jpeds.2016.04.048
29. Parry RH, Brown K. Teaching and Learning communication skills in physiotherapy: What is done and how it should be done? Physiotherapy 2009; 95: 294-301. doi:10.1016/j.physio.2009.05.003
30. Grant MS, Jenkins LS. Communication education for pre-licensure nursing students, Nurse Educ Today 2014; 34: 1375-1381. doi: 10.1016/j.nedt.2014.07.009