Front line nurses' experiences with deteriorating ward patients: a qualitative study. (16th October 2013)

• Record Type: Journal Article
• Authors: Chua, W.L.; Mackey, S.; Ng, E.K.C.; Liaw, S.Y.
• Is Part Of: International nursing review. Volume 60:Number 4(2013:Dec.)
• Page Start: 501
• Page End: 509
• Publication Date: 2013-10-16
• Subjects: Nursing -- Periodicals; 610.7305
• DOI: 10.1111/inr.12061
• Languages: English
• ISSNs: 0020-8132

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="inr12061-sec-0001" sec-type="section"> <title>Background</title> <p>Nurses in the general ward are faced with patients who are at high risk of clinical deterioration. Having the key role in performing routine vital signs monitoring, non‐registered nurses such as enrolled nurses are the front line nurses who play a pivotal role in detecting and responding to the deteriorating ward patient.</p> </sec> <sec id="inr12061-sec-0002" sec-type="section"> <title>Aims</title> <p>(1) To explore the experience of enrolled nurses with deteriorating patients in pre‐cardiac arrest situations and (2) to identify strategies to enhance their role in caring for deteriorating ward patients.</p> </sec> <sec id="inr12061-sec-0003" sec-type="section"> <title>Method</title> <p>A qualitative study using critical incident technique was conducted. Fifteen enrolled nurses who had encountered deteriorating ward patients were interviewed. Data were analysed using content analysis.</p> </sec> <sec id="inr12061-sec-0004" sec-type="section"> <title>Findings</title> <p>Three themes emerged describing enrolled nurse's experience with deteriorating patients: recognizing deterioration, responding to deterioration and taking responsibility. Two themes, including educational development and modifying clinical processes, were strategies identified to enhance the ability of enrolled nurses in recognizing and managing deteriorating patients.</p> </sec> <sec id="inr12061-sec-0005" sec-type="section"> <title>Conclusion</title> <p>The study highlighted a need to enhance the ability of front line nurses in recognizing and responding to patient deterioration through nursing education and modifications of clinical processes.</p> </sec> <sec id="inr12061-sec-0006" sec-type="section"> <title>Implications for Nursing and Health Policy</title> <p>Nursing education could focus on increasing the awareness of the importance of performing complete vital signs monitoring and undertaking accurate interpretation of vital signs. Strategies to improve clinical processes could include the need for registered nurses to provide supervision of enrolled nurses in the interpretation of vital signs readings and share the responsibility of performing vital signs monitoring.</p> </sec> </abstract>