Aims and Objectives: To identify and synthesise empirical evidence on the perspectives of nurses regarding factors that enable and/or obstruct the delivery of compassionate care. Methodological Design and Justification: A scoping review was chosen for its capacity to perform a broad exploration of the available literature. Ethical Issues: This scoping review raises no ethical issues. Research Methods: This review includes studies that report enablers and barriers of compassionate care. Both qualitative and quantitative designs were included. The quality of each study was assessed using the Mixed Method Appraisal Tool (MMAT). A narrative synthesis was employed to summarise the results. Instruments: A search was conducted in the electronic databases of MEDLINE and CINAHL (1975–2021). Outcome Measures: Barriers and enablers to compassionate care from nurses' perspectives. Results: Fifteen empirical studies were included in this review. Four themes of enablers and barriers to compassionate care emerged: (1) personal characteristics, (2) professional characteristics, (3) patient-related factors, and (4) workplace-related factors. Main facilitators were a strong motivation to deliver compassionate care, the managements' support of compassion as a nursing value and operating in a healthy team culture. Main barriers were the absence of education and/or role models for compassionate care, heavy workloads, and the managements' prioritisation of task-centred care. Study Limitations: This study is limited by the inclusion of qualitative studies with small samples and the absence of data from Northern Europe and North America. Conclusions: The findings indicate that policymakers, healthcare leaders, and nursing management play an important role in nurses' ability to provide compassionate care. Through leadership that centralises compassion as a core nursing value, nurses receive greater support in prioritising compassion in patient care. This support is further enhanced by ensuring adequate staffing and manageable schedules, offering comprehensive training in compassionate care skills, and providing resources to support nurses' wellbeing. Trial Registration: PROSPERO: CRD42022324955 https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=324955.
Objectives: To understand healthcare professionals' experiences and perceptions of nurses' potential or ideal roles in pharmaceutical care (PC). Design: Qualitative study conducted through semi-structured in-depth interviews. Setting: Between December 2018 and October 2019, interviews were conducted with healthcare professionals of 14 European countries in four healthcare settings: hospitals, community care, mental health and long-term residential care. Participants: In each country, pharmacists, physicians and nurses in each of the four settings were interviewed. Participants were selected on the basis that they were key informants with broad knowledge and experience of PC. Data collection and analysis: All interviews were conducted face to face. Each country conducted an initial thematic analysis. Consensus was reached through a face-to-face discussion of all 14 national leads. Results: 340 interviews were completed. Several tasks were described within four potential nursing responsibilities, that came up as the analysis themes, being: 1) monitoring therapeutic/adverse effects of medicines, 2) monitoring medicines adherence, 3) decision making on medicines, including prescribing 4) providing patient education/information. Nurses' autonomy varied across Europe, from none to limited to a few tasks and emergencies to a broad range of tasks and responsibilities. Intended level of autonomy depended on medicine types and level of education. Some changes are needed before nursing roles can be optimised and implemented in practice. Lack of time, shortage of nurses, absence of legal frameworks and limited education and knowledge are main threats to European nurses actualising their ideal role in PC. Conclusions: European nurses have an active role in PC. Respondents reported positive impacts on care quality and patient outcomes when nurses assumed PC responsibilities. Healthcare professionals expect nurses to report observations and assessments. This key patient information should be shared and addressed by the interprofessional team. The study evidences the need of a unique and consensus-based PC framework across Europe.
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Little is known about how COVID-19 affects older patients living at home or how it affects district nursing teams providing care to these patients. This study aims to (1) explore, from the perspectives of Dutch district nurses, COVID-19′s impact on patients receiving district nursing care, district nursing teams, and their organisations during the first outbreak in March 2020 as well as one year later; and (2) identify the needs of district nurses regarding future outbreaks. A mixed-methods, two-phase, sequential exploratory design was followed. In total, 36 district nurses were interviewed during the first outbreak (March 2020), of which 18 participated in the follow-up questionnaire in April 2021. Thirteen themes emerged, which showed that the COVID pandemic has substantially impacted patient care and district nursing teams. During the first outbreak, nurses played a crucial role in organising care differently and worked under high pressure, leading to exhaustion, tiredness, and psychosocial problems, including fear of infection. A year later, nurses were better prepared to provide COVID care, but problems regarding work pressure and mental complaints remained. The identified needs focus on a sustainable implementation of leadership roles for district nurses. At the organisational and national levels, more support and appreciation are needed in terms of trust and appropriate policies.
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