TY - JOUR
T1 - Surveillance
T2 - A Nursing Intervention for Improving Patient Safety in Critical Care Environment
AU - Pfrimmer, Dale M.
AU - Johnson, Maren R.
AU - Guthmiller, Martha L.
AU - Lehman, Joanna L.
AU - Ernste, Vickie K.
AU - Rhudy, Lori M.
N1 - Publisher Copyright:
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Nursing surveillance has been identified as a key intervention in early recognition and prevention of errors/adverse events. Nursing Intervention Classification (NIC) defines surveillance as "the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making." Because nurses are the main staffing constant in the critical care environment, the importance of surveillance as an intervention is fundamental. Objective: The aim of this study was to explore how surveillance is expressed by critical care nurses. Methods: A descriptive exploratory research design was used. Think-aloud was used for data collection. Twenty-one registered nurses from 3 critical care units participated in the study. Participants were asked to say out loud whatever they were thinking as they performed patient care at 3 time points: during handoff, initial patient assessment, and after 4 hours of care. Think-aloud (saying aloud what one is thinking) represents the information (cues) that is attended to in short-term memory, before it has been processed and stored. Data were analyzed using content analysis with key concepts and themes identified. Results: The expression of surveillance was through the main theme of finding meaning. Surveillance involved (a) knowing the patient, (b) shared understanding and decision making, and (c) thinking ahead. The outcomes of these activities were aimed at finding meaning in the cues that emerged as the overarching theme. Discussion: Surveillance was expressed through nurses' gathering cues, reflecting on past knowledge, asking questions, verifying, and pulling it all together to find meaning. During handoff, surveillance involved collaborative cognitive work to find meaning in cues.
AB - Background: Nursing surveillance has been identified as a key intervention in early recognition and prevention of errors/adverse events. Nursing Intervention Classification (NIC) defines surveillance as "the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making." Because nurses are the main staffing constant in the critical care environment, the importance of surveillance as an intervention is fundamental. Objective: The aim of this study was to explore how surveillance is expressed by critical care nurses. Methods: A descriptive exploratory research design was used. Think-aloud was used for data collection. Twenty-one registered nurses from 3 critical care units participated in the study. Participants were asked to say out loud whatever they were thinking as they performed patient care at 3 time points: during handoff, initial patient assessment, and after 4 hours of care. Think-aloud (saying aloud what one is thinking) represents the information (cues) that is attended to in short-term memory, before it has been processed and stored. Data were analyzed using content analysis with key concepts and themes identified. Results: The expression of surveillance was through the main theme of finding meaning. Surveillance involved (a) knowing the patient, (b) shared understanding and decision making, and (c) thinking ahead. The outcomes of these activities were aimed at finding meaning in the cues that emerged as the overarching theme. Discussion: Surveillance was expressed through nurses' gathering cues, reflecting on past knowledge, asking questions, verifying, and pulling it all together to find meaning. During handoff, surveillance involved collaborative cognitive work to find meaning in cues.
KW - Decision making
KW - Handoff
KW - Information processing
KW - Surveillance
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UR - http://www.scopus.com/inward/citedby.url?scp=85006298222&partnerID=8YFLogxK
U2 - 10.1097/DCC.0000000000000217
DO - 10.1097/DCC.0000000000000217
M3 - Article
C2 - 27902662
AN - SCOPUS:85006298222
SN - 0730-4625
VL - 36
SP - 45
EP - 52
JO - Dimensions of Critical Care Nursing
JF - Dimensions of Critical Care Nursing
IS - 1
ER -