An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration

Bucknall, Tracey K., Forbes, Helen, Phillips, Nicole M., Hewitt, Nicky A., Cooper, Simon and Bogossian, Fiona (2016) An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration. Journal of Advanced Nursing, 72 10: 2482-2494. doi:10.1111/jan.13009


Author Bucknall, Tracey K.
Forbes, Helen
Phillips, Nicole M.
Hewitt, Nicky A.
Cooper, Simon
Bogossian, Fiona
Title An analysis of nursing students' decision-making in teams during simulations of acute patient deterioration
Journal name Journal of Advanced Nursing   Check publisher's open access policy
ISSN 0309-2402
1365-2648
Publication date 2016-01-01
Year available 2016
Sub-type Article (original research)
DOI 10.1111/jan.13009
Open Access Status Not yet assessed
Volume 72
Issue 10
Start page 2482
End page 2494
Total pages 13
Place of publication Chichester, West Sussex, United Kingdom
Publisher Wiley-Blackwell Publishing
Language eng
Subject 2900 Nursing
Abstract ' Aim. The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions.
Formatted abstract
Aim
The aim of this study was to examine the decision-making of nursing students during team based simulations on patient deterioration to determine the sources of information, the types of decisions made and the influences underpinning their decisions.

Background

Missed, misinterpreted or mismanaged physiological signs of deterioration in hospitalized patients lead to costly serious adverse events. Not surprisingly, an increased focus on clinical education and graduate nurse work readiness has resulted.

Design
A descriptive exploratory design.

Methods
Clinical simulation laboratories in three Australian universities were used to run team based simulations with a patient actor. A convenience sample of 97 final-year nursing students completed simulations, with three students forming a team. Four teams from each university were randomly selected for detailed analysis. Cued recall during video review of team based simulation exercises to elicit descriptions of individual and team based decision-making and reflections on performance were audio-recorded post simulation (2012) and transcribed.

Results
Students recalled 11 types of decisions, including: information seeking; patient assessment; diagnostic; intervention/treatment; evaluation; escalation; prediction; planning; collaboration; communication and reflective. Patient distress, uncertainty and a lack of knowledge were frequently recalled influences on decisions.

Conclusions
Incomplete information, premature diagnosis and a failure to consider alternatives when caring for patients is likely to lead to poor quality decisions. All health professionals have a responsibility in recognizing and responding to clinical deterioration within their scope of practice. A typology of nursing students’ decision-making in teams, in this context, highlights the importance of individual knowledge, leadership and communication.
Keyword Nursing
Nursing
Q-Index Code C1
Q-Index Status Provisional Code
Grant ID ID11-1914
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: HERDC Pre-Audit
School of Nursing, Midwifery and Social Work Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 4 times in Scopus Article | Citations
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Created: Thu, 16 Jun 2016, 21:47:35 EST by Dr Fiona Bogossian on behalf of School of Nursing, Midwifery and Social Work