2.50
Hdl Handle:
http://hdl.handle.net/10755/155778
Type:
Presentation
Title:
Variability In Critical Care Nurses' Haemodynamic Decision Making
Abstract:
Variability In Critical Care Nurses' Haemodynamic Decision Making
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Currey, Judy
P.I. Institution Name:Deakin University
Objective: To explore the extent and sources of variability in critical care nurses' haemodynamic decision-making in the immediate two hour period following cardiac surgery. Design: The study was based on Naturalistic Decision Making (NDM). It was nonexperimental and exploratory in design using observation of practice and interviews with nurses. Sample, Setting: Eight critical care nurses were recruited through purposive sampling from two critical care units in two major metropolitan hospitals in Melbourne in 2000. Methods: Nurses were observed for two-hour periods that commenced when a patient was admitted to the critical care unit after cardiac surgery. This was followed immediately by a follow-up interview to clarify observation data. Observation data and interviews were audio-taped to allow for transcription for analysis. A self-administered survey was used to elicit demographic and cardiac nursing experience information. Findings: The major themes that emerged related to the role of other members of the team in decision-making and variability in the use of therapeutic equipment and technology in decision-making. Team decision-making (TDM) was found to either be Integrated or Parallel. Parallel TDM occurred more frequently with inexperienced nurses where more experienced nurses, when assisting, would assume responsibility for patient-related decisions whereas in Integrated TDM, nurses assisting the primary nurse would defer decisions. This was more common where the primary nurse was experienced. Variability in therapeutic decision-making was noted in deriving assessment cues from technology, and in implementing active warming, an intervention to manage hypothermia. Conclusions: The findings of this study have implications for the educational preparation and ongoing education of critical care nurses to ensure that practice is evidenced based. Attention needs to be given to preparing nurses for team decision-making. Further research is warranted to gain a deeper understanding of the issues involved, with a view to testing relationships between decisions made and patient outcomes.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleVariability In Critical Care Nurses' Haemodynamic Decision Makingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/155778-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Variability In Critical Care Nurses' Haemodynamic Decision Making</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Currey, Judy</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Deakin University</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">currey@deakin.edu.au</td></tr><tr><td colspan="2" class="item-abstract">Objective: To explore the extent and sources of variability in critical care nurses' haemodynamic decision-making in the immediate two hour period following cardiac surgery. Design: The study was based on Naturalistic Decision Making (NDM). It was nonexperimental and exploratory in design using observation of practice and interviews with nurses. Sample, Setting: Eight critical care nurses were recruited through purposive sampling from two critical care units in two major metropolitan hospitals in Melbourne in 2000. Methods: Nurses were observed for two-hour periods that commenced when a patient was admitted to the critical care unit after cardiac surgery. This was followed immediately by a follow-up interview to clarify observation data. Observation data and interviews were audio-taped to allow for transcription for analysis. A self-administered survey was used to elicit demographic and cardiac nursing experience information. Findings: The major themes that emerged related to the role of other members of the team in decision-making and variability in the use of therapeutic equipment and technology in decision-making. Team decision-making (TDM) was found to either be Integrated or Parallel. Parallel TDM occurred more frequently with inexperienced nurses where more experienced nurses, when assisting, would assume responsibility for patient-related decisions whereas in Integrated TDM, nurses assisting the primary nurse would defer decisions. This was more common where the primary nurse was experienced. Variability in therapeutic decision-making was noted in deriving assessment cues from technology, and in implementing active warming, an intervention to manage hypothermia. Conclusions: The findings of this study have implications for the educational preparation and ongoing education of critical care nurses to ensure that practice is evidenced based. Attention needs to be given to preparing nurses for team decision-making. Further research is warranted to gain a deeper understanding of the issues involved, with a view to testing relationships between decisions made and patient outcomes.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T14:09:55Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T14:09:55Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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