The Effectiveness of Nurse Managers’ Strategies in Implementing the Fundamentals of Care Framework: a validation and descriptive study

The "Fundamentals of Care" (FoC) represent a cornerstone of nursing care, focused on meeting patients' physical, psychosocial, and relational needs. The FoC approach is distinguished by its holistic nature, going beyond the execution of clinical/ care procedures to include respect for patient dignity, appropriate communication, and the promotion of comfort and overall well-being. Despite the growing emphasis on FoC in nursing practice, evidence suggests that implementing this care model still faces challenges, particularly regarding uniform application and organizational support. Objectives: This study aims to validate a tool developed to assess ward nurse coordinators’ perceptions of the effectiveness of their strategies in supporting the care team in delivering fundamental care. Methods: The questionnaire was validated using the “Survey Research Methods” methodology, through the systematic administration of questionnaires to a representative sample of individuals or groups to collect information on the study topics. The questionnaire was directly administered to nurse coordinators in clinical inpatient settings and included a series of structured, closed-ended questions designed to assess the application of FoC in nursing practice, challenges in implementation, and their knowledge and perceptions regarding the importance of Fundamentals of Care in the patient care process. Results: Data analysis revealed significant findings regarding the effectiveness of the assessment tool. The questionnaire demonstrated excellent reliability, with a Cronbach's Alpha coefficient of 0.89, indicating high internal consistency of the questions. Seventy-eight percent of coordinators reported perceiving their strategies as effective in supporting the team in delivering fundamental care. Sixty-five percent of respondents identified ongoing staff training as the most effective strategy for improving care quality. Additionally, 85% of participants highlighted the importance of consistent feedback from the team to optimize care strategies. These findings suggest that coordinators have a positive perception of their leadership actions and that the questionnaire is a valid tool for monitoring these perceptions. Conclusions: The study results indicate that the "PILOT NM-FoC/2023" questionnaire is a valid tool for evaluating the effectiveness of FoC implementation strategies. This pilot study suggests that, with appropriate modifications, the questionnaire could be used on a larger scale to provide more generalizable data, significantly contributing to improving the quality of nursing care. Overall, the findings show that to support the adoption and implementation of the FoC model, greater organizational focus is needed, including strengthening corporate policies with a particular emphasis on ongoing staff training in the use of FoC.