Mushta Jane, L Rush Kathy, Andersen Elizabeth
Emergency Department, Interior Health Authority, Kelowna, Canada.
School of Nursing, Faculty of Health and Social Development, University of British Columbia, Kelowna, Canada.
Nurs Forum. 2018 Jan;53(1):84-92. doi: 10.1111/nuf.12215. Epub 2017 Jul 19.
The aim of this concept analysis was to clarify failure to rescure as a nurse-sensitive indicator. Although the concept of failure to rescue as a nurse-sensitive outcome has appeared in the nursing literature for over a decade, conceptual clarity is needed to address its variable and ambiguous use in health care.
Walker and Avant's eight-stage method of concept analysis was used to explore the concept of failure to rescue in nursing practice. Twenty-one papers were retrieved from Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE databases and selected for review and synthesis.
Failure to rescue as a nurse-sensitive indicator was found to be a "failing to rescue" process characterized by a cascade of events, including four key attributes: (1) errors of omission in care, (2) failure to recognize changes in patient condition, (3) failure to communicate changes, and (4) failures in clinical decision making.
Nurses have a pivotal role in "failing to rescue" through early recognition, escalation, and intervention of subtle changes signaling complications. Upstream strategies, such as the use of early warning sign indicators, structured communication, and teamwork, shift the discourse from failure to rescue, to processes in nursing practice of good catch events.
本概念分析的目的是阐明未能挽救这一护士敏感指标。尽管未能挽救这一概念作为护士敏感结局已在护理文献中出现了十多年，但仍需要概念上的清晰性来解决其在医疗保健中使用的多变性和模糊性。
采用沃克和阿万特的八阶段概念分析方法来探讨护理实践中未能挽救的概念。从护理及相关健康文献累积索引（CINAHL）和医学期刊数据库（MEDLINE）中检索出21篇论文，并选择进行综述和综合分析。
未能挽救作为护士敏感指标被发现是一个以一系列事件为特征的“未能挽救”过程，包括四个关键属性：（1）护理中的疏忽错误，（2）未能识别患者病情变化，（3）未能传达变化，以及（4）临床决策失误。
护士在通过早期识别、升级处理和干预预示并发症的细微变化来“未能挽救”方面起着关键作用。上游策略，如使用早期预警信号指标、结构化沟通和团队合作，将讨论从未能挽救转向护理实践中良好捕捉事件的过程。
