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重症监护领域的护理决策

Nursing decision making in critical care areas.

作者信息

Baumann A, Bourbonnais F

出版信息

J Adv Nurs. 1982 Sep;7(5):435-46. doi: 10.1111/j.1365-2648.1982.tb00260.x.

DOI:10.1111/j.1365-2648.1982.tb00260.x
PMID:6924671
Abstract

This exploratory study sought to identify factors that critical care nurses consider relevant in making rapid patient care decisions; to explore the decision making of these nurses in crisis situations; and to identify critical patient care situations where rapid nursing decisions are made. The convenience sample consisted of 50 nurses in critical care settings. A semi-structured interview with a critical care case study was utilized to examine the nurses' decision making. Open ended responses were transformed into fixed categories for tabulation. The findings suggested that: 1 knowledge and experience were the most important factors influencing rapid decision making; 2 although the nurses identified the appropriate decisions in a given crisis situation they had difficulty providing a theoretical rationale for their decisions; 3 the given case study and the 50 crisis situations identified by the subjects indicated that many nursing decisions for critically ill patients were carried out prior to physician assistance. A demographic data questionnaire that examined age, nursing experience, formal education and continuing education of the subjects determined that the majority of the nurses were under 30 years old, had either less than 1 year experience or 7-9 years in critical care, were graduates of a 2-year diploma programme, and took continuing education courses at the community college level.

摘要

这项探索性研究旨在确定重症监护护士在做出快速患者护理决策时认为相关的因素;探讨这些护士在危机情况下的决策过程;并确定做出快速护理决策的关键患者护理情况。便利样本包括50名重症监护环境中的护士。通过对一个重症监护案例研究进行半结构化访谈来考察护士的决策过程。开放式回答被转化为固定类别以便制表。研究结果表明:1. 知识和经验是影响快速决策的最重要因素;2. 尽管护士们在特定危机情况下能确定适当的决策,但他们难以对自己的决策提供理论依据;3. 给定的案例研究以及受试者确定的50种危机情况表明,许多针对重症患者的护理决策是在医生协助之前做出的。一份调查受试者年龄、护理经验、正规教育和继续教育情况的人口统计学数据问卷显示,大多数护士年龄在30岁以下,在重症监护方面的经验不足1年或为7至9年,是两年制文凭课程的毕业生,并且参加社区学院层面的继续教育课程。

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