Nurses' experiences of fundamental care delivery in the intensive care unit: A qualitative systematic review

Fundamental care is relationship-based care delivered by nurses in an integrated manner to meet patients' essential physical, relational, and psychosocial needs. Research on patients' and families' experiences in the intensive care unit (ICU) has reported deficits in fundamental care delivery, leading to poor patient experiences and suboptimal recovery. Understanding nurses' experience of delivering fundamental care in this context can shed light on these poor experiences. This review sought to answer the following question: "What are nurses' experiences of fundamental care delivery in the ICU?"

A qualitative systematic review was conducted following JBI methods.

A systematic search of five electronic databases was undertaken on January 31, 2025: MEDLINE, Cumulative Index for Nursing and Allied Health (CINAHL), APA PsycINFO, Scopus, and Emcare. A total of 5498 papers were retrieved.

A total of 3750 papers were screened after duplicate removal, with 25 papers meeting eligibility criteria. All were independently critically appraised by two authors.

Twenty-five papers representing 785 participants were included. Relationship development between nurses and patients was important for nurses to deliver fundamental care. When nurses were unable to develop these relationships, they felt unable to optimally meet patients' fundamental care needs, resulting in nurses experiencing feelings of frustration and failure. Several strategies were utilised by nurses to develop relationships and deliver fundamental care: getting to know patients, empathy, reassurance, touch, comfort, and informing and involving patients and families. However, nurses also articulated challenges in developing relationships and delivering fundamental care, including patient-specific, nurse-specific, and contextual factors.

This review provides insights into nurses' experiences of fundamental care delivery in the ICU. Given the negative emotions nurses experience when they encounter challenges in delivering fundamental care, research is required to explore ways in which nurses can be better supported to deliver fundamental care in the ICU. The identified strategies might be helpful for nurses to utilise; however, research on their feasibility and effectiveness is warranted.

The systematic review followed an a priori protocol, registered with in the International Prospective Register of Systematic Reviews (PROSPERO [CRD42023428325]).