Exploring Patient Assessment Practices in the Acute Hospital Environment: An Ethnography

2.50
Hdl Handle:
http://hdl.handle.net/10755/335405
Category:
Full-text
Type:
Presentation
Title:
Exploring Patient Assessment Practices in the Acute Hospital Environment: An Ethnography
Other Titles:
Symposium: More Than Vital Signs: Reframing Nurses Recognition and Response to Clinical Deterioration
Author(s):
Osborne, Sonya R.
Lead Author STTI Affiliation:
Phi Delta
Author Details:
Sonya R. Osborne, RN, BSN, GradCert (Periop Nsg), GradCert (HigherEd), MN, PhD, s.osborne@qut.edu.au
Abstract:
Session presented on Friday, July 25, 2014: Purpose: In Australia, as in other countries, recognising and responding to clinical deterioration in hospitalised patients has become a national priority. Ward nurses play an essential role in detecting acute care patients at risk of clinical deterioration through attentive surveillance, diligent assessment, and timely intervention. Much attention in the literature has been given to the efferent limb of the clinical deterioration pathway, such as hospitals' implementation of the use of early warning scores, track and trigger systems, and rapid response teams. Yet, unrecognised clinical deterioration continues to be a significant problem. The literature is consistent in viewing the situation of clinical deterioration from the perspective of improving detection and documentation of clinical deterioration with scant attention to the nature of assessment practices. The purpose of the study was to improve understanding of the unexamined factors that influence patient assessment practices by exploring patterns of behaviour, and interpersonal, cultural and geographical factors related to nursing assessment practices in the acute care hospital environment. Methods: The study design was a hospital ethnography using participant observation and informal and formal interviews. Data, collected in the form of field notes and transcribed audio-recorded interviews, was analysed using an iterative process. Results: Nurses' assessment and surveillance of patients is practiced in the context of the medical emergency response framework. As such this creates a culture that dominates and dictates a focus on monitoring and recording of patient's vital signs for medical team review and response. This focus influences multidisciplinary relationships and roles and the organisation factors that govern nurses' work. Conclusion: The study findings illustrate the complex interplay of factors that influence nurses' assessment practice in the acute care setting. Development of holistic picture of patient assessment practices will inform development of effective health service improvements in managing patients at risk for clinical deterioration.
Keywords:
nursing assessment; patient safety; clinical deterioration
Repository Posting Date:
17-Nov-2014
Date of Publication:
11 ; 11
Other Identifiers:
INRC14D11
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePresentationen
dc.titleExploring Patient Assessment Practices in the Acute Hospital Environment: An Ethnographyen
dc.title.alternativeSymposium: More Than Vital Signs: Reframing Nurses Recognition and Response to Clinical Deteriorationen
dc.contributor.authorOsborne, Sonya R.en
dc.contributor.departmentPhi Deltaen
dc.author.detailsSonya R. Osborne, RN, BSN, GradCert (Periop Nsg), GradCert (HigherEd), MN, PhD, s.osborne@qut.edu.auen
dc.identifier.urihttp://hdl.handle.net/10755/335403-
dc.description.abstractSession presented on Friday, July 25, 2014: Purpose: In Australia, as in other countries, recognising and responding to clinical deterioration in hospitalised patients has become a national priority. Ward nurses play an essential role in detecting acute care patients at risk of clinical deterioration through attentive surveillance, diligent assessment, and timely intervention. Much attention in the literature has been given to the efferent limb of the clinical deterioration pathway, such as hospitals' implementation of the use of early warning scores, track and trigger systems, and rapid response teams. Yet, unrecognised clinical deterioration continues to be a significant problem. The literature is consistent in viewing the situation of clinical deterioration from the perspective of improving detection and documentation of clinical deterioration with scant attention to the nature of assessment practices. The purpose of the study was to improve understanding of the unexamined factors that influence patient assessment practices by exploring patterns of behaviour, and interpersonal, cultural and geographical factors related to nursing assessment practices in the acute care hospital environment. Methods: The study design was a hospital ethnography using participant observation and informal and formal interviews. Data, collected in the form of field notes and transcribed audio-recorded interviews, was analysed using an iterative process. Results: Nurses' assessment and surveillance of patients is practiced in the context of the medical emergency response framework. As such this creates a culture that dominates and dictates a focus on monitoring and recording of patient's vital signs for medical team review and response. This focus influences multidisciplinary relationships and roles and the organisation factors that govern nurses' work. Conclusion: The study findings illustrate the complex interplay of factors that influence nurses' assessment practice in the acute care setting. Development of holistic picture of patient assessment practices will inform development of effective health service improvements in managing patients at risk for clinical deterioration.en
dc.subjectnursing assessmenten
dc.subjectpatient safetyen
dc.subjectclinical deteriorationen
dc.date.available2014-11-17T13:51:42Z-
dc.date.issued11/17/2014-
dc.date.issued11/17/2014en
dc.date.accessioned2014-11-17T13:51:42Z-
dc.conference.date2014en
dc.conference.name25th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationHong Kongen
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen
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