Butler Clare
Faculty of Health and Life Sciences, Oxford Brookes University, Jack Straws Lane, Oxford, OX3 0FL, United Kingdom.
Nurse Educ Pract. 2018 Jan;28:96-102. doi: 10.1016/j.nepr.2017.10.014. Epub 2017 Oct 13.
The aim of this study was to explore nurses' experiences assessing and managing deteriorating patients in practice following completion of a relevant post-registration education programme. Recognising the increasing acuity of ward patients, nurses are faced with patients who are at an increased risk of deterioration. Patients who are acutely ill or deteriorating often exhibit periods of physiological deterioration; however there is evidence illustrating that these clinical changes are frequently missed, misinterpreted or mismanaged in practice. In order to prepare nurses to competently assess and manage the deteriorating patient, education as a care initiative is offered to develop the knowledge and skills required. A qualitative study using critical incident analysis was conducted to acquire narrative data from nurses, describing their clinical practice experiences of patient deterioration. Thematic analysis was used to analyse the data. Findings revealed improvements in nurses' abilities to recognise patient deterioration, greater application of the evidence base and an increase in confidence and assertiveness. There was some evidence of applying the knowledge and skills learned, however equally some nurses indicated that they remained ill-prepared to apply the skills in practice.
本研究的目的是探讨护士在完成相关注册后教育项目后，在实际工作中评估和管理病情恶化患者的经验。认识到病房患者病情的日益严重，护士面临着病情恶化风险增加的患者。急病或病情恶化的患者常常会出现生理状况恶化的时期；然而，有证据表明，这些临床变化在实际工作中经常被忽视、误解或处理不当。为了让护士有能力胜任评估和管理病情恶化的患者，作为一项护理举措提供了教育，以培养所需的知识和技能。采用关键事件分析法进行了一项定性研究，以获取护士描述其患者病情恶化临床实践经验的叙述性数据。使用主题分析法对数据进行分析。研究结果显示，护士识别患者病情恶化的能力有所提高，循证依据的应用更加广泛，信心和主见性也有所增强。有一些应用所学知识和技能的证据，然而同样有一些护士表示，他们在实际工作中仍未做好应用这些技能的准备。
