The concept of „Routine care“ and „Usual care“ in the nursing discipline: a multi-method study. (in: The 20th European Doctoral Conference in Nursing Science – EDCNS)

Introduction: The term “Routine” is used in various fields of knowledge with multiple connotations. In nursing, it remains poor developed and inconsistently defined in literature. This study aims to define “Routine care” and “Usual care” in nursing, exploring their implications in clinical, research and educational contexts. Methods: A multi-method approach. In the first phase, a systematic review synthesized definition of “Routine care” and “Usual care” following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis—guidelines. The second phase involved semi-structured interviews with multiple stakeholders (nurses, physicians, patients, caregiver, students) to explore the concept at the practical levels. Results: From 27,364 studies, the 10 articles included identified 16 thematic areas defining “Routine care” and “Usual care”. “Routine care” was mainly characterized by repeated activities over time. Nineteen semi-structured interviews were conducted, involving 7 nursing students, 4 nurse manager, 2 patients, 2 caregivers and 4 physicians, who reported heterogeneity in the interpretation of these concepts. Conclusion: Concepts of “usual care” and “routine care” are not equivalent still and appear poorly conceptually and practically defined. “Routine care” are oriented towards work efficiency, and it is influenced by temporal, relational, cultural and ritual factors. The “usual care” varies considerably between contexts and individuals reflecting mainly the current standards of care. There is a need to further develop these concepts according also to their relevance in comparative or interventional studies.