British and Finnish nurses' attitudes, practice, and knowledge on deteriorating patient in-service education: A study in two acute hospitals. (July 2021)

• Record Type: Journal Article
• Authors: Azimirad, Mina; Magnusson, Carin; Wiseman, Allison; Selander, Tuomas; Parviainen, Ilkka; Turunen, Hannele
• Is Part Of: Nurse education in practice. Volume 54(2021)
• Publication Date: 2021-07
• Subjects: Attitude -- Clinical deterioration -- Competence -- Innovation leadership -- In-service education -- Leadership -- Nurse administrators -- Transformational leadership; Nursing -- Study and teaching -- Periodicals; Education, Nursing -- Periodicals; Nursing -- Study and teaching; Periodicals; Electronic journals; 610.73071
• DOI: 10.1016/j.nepr.2021.103093
• Languages: English
• ISSNs: 1471-5953

Abstract

Abstract: Aim: The aim was to assess both nurses' attitudes about in-service education, and the impact had by attending in-service education on nurses' management and knowledge of deteriorating patients. Background: In-service education cannot reach its best potential outcomes without strong leadership. Nurse managers are in a position of adopting leadership styles and creating conditions for enhancing the in-service education outcomes. Design: We conducted a comparative cross-sectional study between British and Finnish nurses (N = 180; United Kingdom: n = 86; Finland: n = 94). Methods: A modified "Rapid Response Team Survey" was used in data collection. A sample of medical and surgical registered nurses were recruited from acute care hospitals. Self-reporting, self-reflection, and case-scenarios were used to assess nurses' attitudes, practice, and knowledge. Data were analyzed by Mann-Whitney-U and Chi-square tests. Results: Nurses' views on education programs were positive; however, low confidence, delays caused by hospital culture, and fear of criticism remained barriers to post education management of deteriorating patients. Nurses' self-reflection on their management of deteriorating patients indicates that 20–25% of deteriorating patients are missed. Conclusion: Nurse managers should promote a no-blame culture, mitigate unnecessary hospital culture and routines, and facilitate in-service education focusing on identification and management of deteriorating patients, simultaneously improving nurses' confidence. Highlights: In-service education is crucial for improving nurses' competence in acute hospitals. Nurses should actively improve their competence to prevent missed RRS-activation incidents. Nurse managers are clinical leaders who can translate the evidence-based changes. Nurse managers should promote a no-blame culture to improve nurses' confidence. Nurse managers should mitigate unnecessary hospital culture and routines.