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Identifying patient deterioration: Using simulation and reflective interviewing to examine decision making skills in a rural hospital

Citation

Endacott, R and Scholes, J and Cooper, S and McConnell-Henry, T and Porter, J and Missen, K and Kinsman, L and Champion, R, Identifying patient deterioration: Using simulation and reflective interviewing to examine decision making skills in a rural hospital, International Journal of Nursing Studies, 49, (6) pp. 710-717. ISSN 0020-7489 (2012) [Refereed Article]

Copyright Statement

Copyright 2011 Elsevier Ltd.

DOI: doi:10.1016/j.ijnurstu.2011.11.018

Abstract

Objectives: The study aim was to examine how Registered Nurses identify and respond to deteriorating patients during in-hospital simulation exercises.

Design: Mixed methods study using simulated actors.

Setting: A rural hospital in Victoria, Australia.

Participants: Thirty-four Registered Nurses each completed two simulation exercises.

Methods: Data were obtained from the following sources: (a) Objective Structured Clinical Examination (OSCE) rating to assess performance of Registered Nurses during two simulation exercises (chest pain and respiratory distress); (b) video footage of the simulation exercises; (c) reflective interview during participants’ review of video footage. Qualitative thematic analysis of video and interview data was undertaken.

Results: Themes generated from the data were: (1) exhausting autonomous decision-making; (2) misinterpreting the evidence; (3) conditioned response; and (4) missed cues. Assessment steps were more likely to be omitted in the chest pain simulation, for which there was a hospital protocol in place.

Conclusions: Video review revealed additional insights into nurses’ decision-making that were not evident from OSCE scoring alone. Feedback during video review was a highly valued component of the simulation exercises.

Item Details

Item Type:Refereed Article
Keywords:decision making; rural hospitals; safety management; nursing
Research Division:Medical and Health Sciences
Research Group:Public Health and Health Services
Research Field:Public Health and Health Services not elsewhere classified
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Nursing
Author:Kinsman, L (Professor Leigh Kinsman)
ID Code:97767
Year Published:2012
Web of Science® Times Cited:10
Deposited By:Health Sciences B
Deposited On:2015-01-13
Last Modified:2015-04-13
Downloads:0

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