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Nurse decision making in the prearrest period
Priscilla K Gazarian1, Elizabeth A Henneman, Genevieve E Chandler
1University of Massachusetts, Amherst, USA. priscilla.gazarian@gmail.com
Clinical Nursing Research
|December 4, 2009
Summary
Nurses identify patients at risk for cardiopulmonary arrest (CPA) using altered consciousness and early warning scores, combined with patient knowledge. Teamwork and organizational support are crucial for preventing CPA.
Area of Science:
- Clinical Nursing
- Patient Safety
- Critical Care Medicine
Background:
- Hospitalized patients often show signs of deterioration before cardiopulmonary arrest (CPA).
- Early identification and intervention are key to preventing CPA.
- Understanding nurses' decision-making processes is vital for improving patient outcomes.
Purpose of the Study:
- To describe the cues and factors nurses use to identify and interrupt potentially preventable CPAs.
- To explore the role of nurse and organizational characteristics in CPA prevention.
Main Methods:
- Qualitative study utilizing the critical decision method.
- Data collection involved observing and interviewing nurses regarding their identification and intervention strategies for at-risk patients.
Main Results:
- Key cues for identifying at-risk patients included altered level of consciousness and triggers from the Early Warning Scoring System (EWSS).
- Nurses' prior experience and teamwork skills were vital for interrupting adverse events.
- Organizational factors like monitoring equipment, staff flexibility, collaboration, and knowledge access supported nurses' interventions.
Conclusions:
- Nurses integrate multiple cues, including patient-specific data and contextual factors, to predict and prevent CPA.
- Effective CPA prevention relies on skilled nurses, strong teamwork, and supportive organizational structures.
- Further research should focus on optimizing these factors to reduce CPA incidence in hospitals.
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