Using communication to manage missed care: A case study applying the Fundamentals of Care framework

Aim To explore, through the patient's perspective, how patient-provider communication is linked to missed nursing care vs. meeting patients' fundamental care needs. Background Missed nursing care causes severe consequences for patients. Person-centred fundamental care, in which communication is central, provides an approach to manage this challenge. However, the specific patient-provider communications linked to care outcomes are unknown. Methods Case study using secondary analysis of observations and interviews. A purposeful sample of 20 patients with acute abdominal pain collected using ethnographic methodology at one emergency department and two surgical wards. The Fundamentals of Care framework guided the analysis. Results Communications that included the patient as an equal member of the care team were observed to make a difference between adequate and missed nursing care. Four categories were identified: interpersonal respect, humanized context of care, available and accessible communication channels, and mutual holistic understanding of the care needs and care plan. Conclusion Communication can be an essential tool to avoid missed nursing care and address the critical need for nursing managers to restore the fundamentals of care. Implications for Nursing Management Nursing managers can use this new knowledge of communication to facilitate person-centred fundamental care and thereby avoid missed nursing care.