How do Newly Qualified Nurses Apply Decision-Making Models in their Management of Patient Medications: Directions for Improved Quality of Care

2.50
Hdl Handle:
http://hdl.handle.net/10755/163544
Category:
Abstract
Type:
Presentation
Title:
How do Newly Qualified Nurses Apply Decision-Making Models in their Management of Patient Medications: Directions for Improved Quality of Care
Author(s):
Manias, Elizabeth; Aitken, Robyn; Dunning, Trisha
Author Details:
Elizabeth Manias, RN, MPharm, MNursStud, PhD, Associate Professor, The University of Melbourne, School of Nursing, Carlton, Victoria, Australia, email: emanias@unimelb.edu.au; Robyn Aitken, RN Med; Trisha Dunning RN, PhD
Abstract:
Purpose: Newly qualified nurses need to make complex and ever-changing decisions about patients' medications in a clinical environment affected by multifaceted, contextual issues. The objective of the study was to show how decision-making models can be applied to graduate nurses' clinical reasoning processes for patients' medications. The decision-making models considered were: hypothetico-deductive reasoning, pattern recognition and intuition. Methods: Twelve newly qualified nurses involved in direct patient care of an Australian metropolitan teaching hospital participated in the study. Participant observations were conducted over a two-hour period during the times when medications were administered to patients. Clarifying questions were asked of nurses through in-depth individual interviews conducted after observations. A documentation audit was also undertaken of nurses' progress notes and patients' medication orders for patients cared for by nurses during the time of observation. Results: During observations, nurses cared for 47 patients and administered 175 medications. The most common decision-making model used was hypothetico-deductive reasoning (n=25), followed by pattern recognition (n=10) and then intuition (n=2). Nurses had a good understanding of how physical assessment affected whether medications should be administered or not. When negotiating treatment options, nurses readily consulted with more experienced nursing colleagues and doctors. Pattern recognition was more apparent in wards addressing a particular medical specialty, such as cardiothoracic medicine. In these specialty environments nurses paid particular attention to how care was constructed using structured protocols and clinical pathways, and they developed expertise in interpreting specific cues and implementing structured treatments for patients' problems. The two instances of intuition involved nurses' tacit knowledge of changes relating to patients' vital signs. Conclusions and Implications: The complexity of the practice setting means that newly qualified nurses need to adapt rapidly to make sound and appropriate decisions about medication management. Identifying gaps in decision-making will provide directions for improved quality of care.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
17th Annual Scientific Sessions
Conference Host:
Eastern Nursing Research Society
Conference Location:
New York, New York, USA
Description:
�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New York
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleHow do Newly Qualified Nurses Apply Decision-Making Models in their Management of Patient Medications: Directions for Improved Quality of Careen_GB
dc.contributor.authorManias, Elizabethen_US
dc.contributor.authorAitken, Robynen_US
dc.contributor.authorDunning, Trishaen_US
dc.author.detailsElizabeth Manias, RN, MPharm, MNursStud, PhD, Associate Professor, The University of Melbourne, School of Nursing, Carlton, Victoria, Australia, email: emanias@unimelb.edu.au; Robyn Aitken, RN Med; Trisha Dunning RN, PhDen_US
dc.identifier.urihttp://hdl.handle.net/10755/163544-
dc.description.abstractPurpose: Newly qualified nurses need to make complex and ever-changing decisions about patients' medications in a clinical environment affected by multifaceted, contextual issues. The objective of the study was to show how decision-making models can be applied to graduate nurses' clinical reasoning processes for patients' medications. The decision-making models considered were: hypothetico-deductive reasoning, pattern recognition and intuition. Methods: Twelve newly qualified nurses involved in direct patient care of an Australian metropolitan teaching hospital participated in the study. Participant observations were conducted over a two-hour period during the times when medications were administered to patients. Clarifying questions were asked of nurses through in-depth individual interviews conducted after observations. A documentation audit was also undertaken of nurses' progress notes and patients' medication orders for patients cared for by nurses during the time of observation. Results: During observations, nurses cared for 47 patients and administered 175 medications. The most common decision-making model used was hypothetico-deductive reasoning (n=25), followed by pattern recognition (n=10) and then intuition (n=2). Nurses had a good understanding of how physical assessment affected whether medications should be administered or not. When negotiating treatment options, nurses readily consulted with more experienced nursing colleagues and doctors. Pattern recognition was more apparent in wards addressing a particular medical specialty, such as cardiothoracic medicine. In these specialty environments nurses paid particular attention to how care was constructed using structured protocols and clinical pathways, and they developed expertise in interpreting specific cues and implementing structured treatments for patients' problems. The two instances of intuition involved nurses' tacit knowledge of changes relating to patients' vital signs. Conclusions and Implications: The complexity of the practice setting means that newly qualified nurses need to adapt rapidly to make sound and appropriate decisions about medication management. Identifying gaps in decision-making will provide directions for improved quality of care.en_GB
dc.date.available2011-10-27T11:09:24Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:09:24Z-
dc.conference.date2005en_US
dc.conference.name17th Annual Scientific Sessionsen_US
dc.conference.hostEastern Nursing Research Societyen_US
dc.conference.locationNew York, New York, USAen_US
dc.description�Translational Research for Quality Health Outcomes: Affecting Practice and Healthcare Policy�, held on April 7th -9th at the Roosevelt Hotel, New Yorken_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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