How nursing care is expressed among nurse anaesthetists in the perioperative context: A meta-ethnographic synthesis

Abstract

Aim: To develop a conceptual framework describing nursing care from the anaesthesia nurse's perspective in the perioperative context.

Background: Surgical patients find themselves in a vulnerable situation in need of advanced treatment and care. Nurse anaesthetists have a central role in reducing harm and enhance patient safety, in which person-centred care has been identified as a key component. However, they are challenged by productivity and efficiency demands leading to a potential risk to patient safety.

Design: Noblit and Hare's interpretative meta-ethnography, directed by the eMERGe reporting guidance.

Methods: A comprehensive systematic search of nine databases without year limitation. Fifteen studies published between 2002 and 2021 were found eligible for inclusion. Quality appraisal was performed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument.

Results: Four themes were identified: being vigilant to keep safe from harm, strengthening patients' confidence, expressing courage to act and speak up, and endorsing team collaboration to achieve best practice. The themes were synthesised into the metaphor, 'Continuously assessing and acting according to the patients' needs in a holistic perspective'. A conceptual framework was developed, illustrating the interconnection between the different nursing expressions, as the nurse anaesthetists seek to care for the patient as a whole person.

Conclusions: Nurse anaesthetists aim to deliver holistic nursing care. Nursing care is expressed at two levels, foregrounding and backgrounding anaesthetic nursing, in line with the philosophy of person-centred care. Nursing care in anaesthesia is a matter of how and why it is performed, expressed in attitudes toward the recipients of care.

Relevance to clinical practice: The framework may be used to inform educational programs and clinical practice in nurse anaesthesia and to promote person-centred care as a shared value across all levels involved in perioperative patient care.

No patient or public contribution: Data were retrieved from already published literature.

Keywords: meta-ethnography; nurse anaesthesia; nursing; patient safety; perioperative; person-centred care; qualitative research.