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Author
Pirret, A.M.
Title
The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making
Type
Journal Article
Year
2007
Publication
Intensive & Critical Care Nursing
Abbreviated Journal
Volume
23
Issue
3
Pages
145-155
Keywords
Evaluation
;
Intensive care nursing
;
Clinical decision making
;
Nursing
;
Education
Abstract
The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved.
Call Number
NRSNZNO @ research @
Serial
933
Permanent link to this record
Author
Pirret, A.M.
Title
The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making
Type
Year
2005
Publication
Abbreviated Journal
Massey University Library
Volume
Issue
Pages
Keywords
Intensive care nursing
;
Clinical decision making
Abstract
Call Number
NRSNZNO @ research @ 686
Serial
672
Permanent link to this record
Author
Pirret, A.M.
Title
A preoperative scoring system to identify patients requiring postoperative high dependency care
Type
Journal Article
Year
2003
Publication
Intensive & Critical Care Nursing
Abbreviated Journal
Volume
19
Issue
5
Pages
267-275
Keywords
Hospitals
;
Quality of health care
;
Surgery
;
Nursing
;
Clinical assessment
Abstract
The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
Call Number
NRSNZNO @ research @ 904
Serial
888
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