Minor things of major importance-nurses' experience of using the Komfort Bundle when caring for critically ill patients: A qualitative study

Abstract

Introduction: To address discomfort in critically ill patients, we developed the Komfort Bundle. The tool is an illustrated wall-hung board designed to help nurses systematically identify, display, and address individual patient preferences and needs, aiming to enhance comfort.

Objectives: The aim of this study was to explore nurses' experience of using a newly developed Komfort Bundle for critically ill patients.

Methods: An exploratory descriptive study design with focus group interviews was conducted following the implementation of the tool in adult intensive care units across three different Norwegian hospitals. The data were analysed using reflexive thematic analysis.

Findings: One overarching theme, three themes, and six subthemes resulted from the analysis. The overarching theme, "Minor things of major importance", refers to the nurses' perception of the Komfort Bundle's capacity to display information about minor yet significant matters for patients, and subsequently for their family, and for nurses to guide care. The theme "Satisfaction in nursing through person-centred care" highlights how the Bundle facilitated care that was considered meaningful to the patients, thereby leading to satisfaction among the nurses providing the care. The theme "Acknowledging the importance of family members through involvement" expresses that nurses found the Bundle helped facilitate communication with patients' family members and empowered them through involvement. The theme "Balancing content to address patients' actual needs" revealed a concern about the lack of ongoing evaluation of the bundle content and the need to address confidentiality issues.

Conclusion: Nurses found the Komfort Bundle helpful in gaining insights into patients' preferences and needs, enabling more personalised, potentially meaningful care interventions. It facilitated nurses' involvement of family members. The Bundle shows promise as a practical tool. Still, it needs clearer implementation guidelines due to concerns about the lack of regular content evaluation and the need to address confidentiality issues. Research is needed to understand how patients and families experience its impact.

Keywords: Comfort; Critical care; Discomfort; Focus groups; Intensive care nursing; Qualitative research.