TITLE:
Essentials of Nursing Care in Randomized Controlled Trials of Nurse-Led Interventions in Somatic Care: A Systematic Review
AUTHORS:
Bengt Fridlund, A. C. Jönsson, E. K. Andersson, S.-V. Bala, G.-B. Dahlman, A. Forsberg, S. Glasdam, A. Hommel, A. Kristensson, C. Lindberg, B. Sivberg, A. Sjöström-Strand, J. Wihlborg, K. Samuelson
KEYWORDS:
Nurse-Led; Nursing Care; Randomized Controlled Trial; Somatic Care; Systematic Review
JOURNAL NAME:
Open Journal of Nursing,
Vol.4 No.3,
March
5,
2014
ABSTRACT:
Background: Nursing practice has to contribute to evidence pointing out why
there is a need for more nurse-designed randomized control trials (RCTs)
focusing on evidence-based practice (EBP). How far this EBP has progressed in
different health aspects is usually established by systematic reviews of RCTs. Nurse-led
RCTs exist but no study has addressed the essentials of nursing care. Aim: The aim was therefore to determine the essentials
of nurses’ interventions by means of nurse-led RCTs in somatic care focusing on
the stated context, goals, content, strategies as well as the nurse’s role
related to effectiveness. Methods: A systematic review was realized according
to Cochrane review assumptions to identify, appraise and synthesize all
empirical evidence meeting pre-specified eligibility criteria. The PRISMA
statement guided the data extraction process (n = 55) from PubMed and CINAHL. Results: Of the
RCTs in somatic care, 71% showed a positive effectiveness of nurse-led
interventions, of which the nurse had a significant role with regard to being
the main responsible in 67% of the studies. Also, 47% of the RCTs presented a
theoretical standpoint related to the nurse-led interventions and most
prominent were international evidence-based guidelines. Goals were found to
have either a patient-centered or a professional-centered ambition. Strategies
were based on patient-directed initiatives, nurse-patient-directed initiatives
or nurse-directed initiatives, while contents were built upon either a
patient-nurse interaction or a nursing management plan. Conclusions: This
review underlines the necessity of a holistic view of a person, as nurse-led
RCTs comprising a patient-centered ambition, patient-directed initiative and
patient-nurse interaction plan showed beneficial nursing care effectiveness,
particularly if theory-based. In a nurse-led RCT, a basic theoretical
perspective is advantageous as well as to elucidate the role of the nurse in
relation to the estimated effects.