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Role of Communication in the Nursing Process I: Assessment and Diagnosis01:25

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The nursing process uses scientific reasoning, problem-solving, and critical thinking to guide nurses in providing patients with appropriate care. This process is a systematic approach to recognize, avoid, and treat current or potential health issues while promoting the patient's well-being.
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The nursing process is the core of practice for every registered nurse to deliver holistic, patient-focused care. The following are the five steps in the nursing process.
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There are several characteristics related to delivering nursing care. One vital characteristic of the nursing process is that it can be used to protect nurses and justify the provided care. Productive use of the nursing process requires the knowledge and skills of nurses to assess and solve issues. Nurses should develop and strengthen their critical thinking skills and evidence-based nursing interventions to improve their skills in formulating nursing care plans. A well-defined approach to...
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What Decision-Making Processes Are Used by Nurses in Initiating, Monitoring, and Ending One-to-One Observations? A

Joel Stanton1, Carol Stiles, Paula Anderson

  • 1Author Affiliations : Nursing & Midwifery Workforce Team, University College London Hospitals NHS Foundation Trust, London, United Kingdom (Mr Stanton); University College London Hospitals NHS Foundation Trust, London, United Kingdom (Mss Stiles, Anderson, Prof Taylor); Department of Targeted Intervention, University College London (UCL), London, United Kingdom (Prof Vindrola-Padros); and Centre for Nurse, Midwife and AHP Research, University College London Hospitals NHS Foundation Trust, London, United Kingdom (Dr Ivany).

Journal of Nursing Care Quality
|May 9, 2025
PubMed
Summary

Nurses lack evidence-based guidelines for one-to-one patient observations in hospitals. This review identified current decision-making tools, finding most lack strong evidence, highlighting a critical gap in patient safety practices.

Keywords:
clinical decision makingdecision aidsone-to-one observationspatient safetysitterssystematic review

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10:38

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Published on: January 16, 2019

Area of Science:

  • Nursing
  • Patient Safety
  • Healthcare Management

Background:

  • Lack of evidence-based processes for one-to-one observations in acute care.
  • Need for standardized approaches to support nurses in patient monitoring.
  • Risk of avoidable harm due to inconsistent observation practices.

Purpose of the Study:

  • Systematically review decision-making processes for one-to-one observations.
  • Identify tools and strategies used by nurses for patient monitoring.
  • Evaluate the evidence base for current observation practices.

Main Methods:

  • Systematic review of five databases (searched July 2020 & July 2024).
  • Inclusion of papers discussing decision-making for one-to-one observations in acute adult inpatients.
  • Thematic analysis of extracted data.

Main Results:

  • Sixteen publications were included in the review.
  • Identified decision-making tools: assessment tools, local processes, and clinical judgment.
  • Most common tool was institutional processes combining clinical assessment and action guidance.

Conclusions:

  • Various tools facilitate one-to-one observation decisions.
  • Few existing tools are evidence-based.
  • Significant gap exists in evidence supporting current observation decision-making processes.