Detailing experienced nurse decision making during acute patient care simulations

Nurse decision making (DM) is critical for patient safety. Eye-tracking methods can effectively assess nurse DM. The purpose of this pilot study was to use eye-tracking methods to assess nurse DM during a clinical simulation.

Experienced nurses managed a simulated patient manikin who suffered from a stroke mid-simulation. We assessed nurses' gaze patterns prior to and after the stroke. DM in general was assessed by nursing faculty using a clinical judgement rubric, and dichotomously based on recognition of the stroke or not.

Data from eight experienced nurses was examined. For the nurses who recognized the stroke, visual attention was focused on the vital sign monitor and patient's head, which suggest those locations were consistently examined for correct decision-makers.

Dwell time on general AOIs was associated with poorer DM, which may reflect poorer pattern recognition. Eye-tracking metrics may be effective to objectively assess nurse DM.