Patient centred care in nursing – opportunities for implementation in Romania acute care units

Article type
Authors
Mazilu D1, Dobre C1, Gagiu C2, Stan D3, Mareș A4, Nedelcu V1, Zazu M1
1OAMGMAMR Bucharest Branch; Romanian Centre for Nursing Research: A JBI Centre of Excellence, Bucharest, Romania; Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
2OAMGMAMR Bucharest Branch; Romanian Centre for Nursing Research: A JBI Centre of Excellence, Bucharest, Romania; Prof. Dr. Alexandru Obregia Psychiatry Hospital, Bucharest, Romania
3OAMGMAMR Bucharest Branch; Romanian Centre for Nursing Research: A JBI Centre of Excellence, Bucharest, Romania; Clinical Hospital of Obstetrics and Gynecology “Prof. Dr. Panait Sârbu”, Bucharest, Romania
4OAMGMAMR Bucharest Branch; Romanian Centre for Nursing Research: A JBI Centre of Excellence, Bucharest, Romania; Emergency Hospital Bagdasar-Arseni, Bucharest, Romania
Abstract
Background
Patient centred care (PCC) is a globally recognized evidence based practice to ensure quality and safe health care. Nurses and midwives, as members of the medical team, have an essential responsibility to provide health care with a focus on the patient's values and preferences. In Romania, the studies from 2018-2019 highlighted numerous barriers to this concept implementation. The main goal is to develop an adequate framework for the implementation of PCC taking into account the international experience in the field (published data from international research) and the social, political and cultural framework in Romania.

Method
A rapid review was conducted in five databases JBI, Cochrane Library, Medline, CINAHL, and SCOPUS. We searched for full-text articles published up to February 2024 on patient-centred care in the acute care setting in the nursing context. A number of 85 relevant articles were selected. The data analysis and synthesis were processed and interpreted to understand the topic's broad character.

Results
The national POLMED project results (2018-2019) highlight the local nature of health care, focusing on tasks and less on the patient. The main reasons are the burden of responsibilities (including from medical doctors), reduced number of nursing staff, limited interaction time with the patient, and reduced quality level of professional education. In the secondary data analysis (at the international level), we identified the characteristic components of the PCC concept: (1) Nursing Staff engagement (Consistent delivery of health care according to the identified needs; Safe environment; Respect; Understanding), (2) Competence and Leadership (Knowledge and skills; Time spent with patients; Support for patients self-management; Effective communication), (3) Patient and family engagement (Own health care decisions; Trust and safety feeling; Opportunities to express one's values and beliefs; Confidentiality, Fundamental rights, Valorization, Inclusion and Social Equity).

Conclusion
Implementing the PCC model in current clinical practice is challenging. However, identifying the main facilities for limiting these barriers can be an effective strategy for the PCC implementation in Romania.