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Frontline Nurses' clinical judgment in recognizing, understanding, and responding to patient deterioration: A
Susan Dresser1, Cynthia Teel2, Jill Peltzer2
1Fran and Earl Ziegler College of Nursing, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
International Journal of Nursing Studies
|February 2, 2023
Summary
Nurses
Area of Science:
- Nursing
- Patient Safety
- Clinical Judgment
Background:
- Early warning systems and rapid response teams are common in hospitals.
- These systems have had limited success in preventing adverse patient events.
- Nurses' clinical judgment is crucial for recognizing and responding to patient deterioration.
Purpose of the Study:
- To explore medical-surgical nurses' perceptions of factors influencing their clinical judgment when patients deteriorate.
Main Methods:
- Qualitative descriptive study utilizing semi-structured interviews.
- Tanner's Clinical Judgment Model guided the interview questions and analysis.
- 20 medical-surgical nurses from 10 units participated.
Main Results:
- Eight themes emerged, including patient knowledge, experience, system failures, data interpretation, teamwork, and workload.
- Nurses' sense of responsibility was an overarching theme.
- Factors related to the nurse, patient, and work environment impact clinical judgment.
Conclusions:
- Healthcare systems should consider nurses' clinical judgment and influencing factors to improve patient deterioration response.
- Further research is needed to understand contextual factors impacting nurses' judgment for better interventions.
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