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 2011 Elsevier Ltd.
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 participantsí 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 nursesí decision-making that were not evident from OSCE scoring alone. Feedback during video review was a highly valued component of the simulation exercises.
|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 Group:||Health and Support Services|
|Author:||Kinsman, L (Professor Leigh Kinsman)|
|Web of Science® Times Cited:||12|
|Deposited By:||Health Sciences B|
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