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Author |
Bickley, J. |
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Title |
A study of medical, nursing, and institutional not-for-resuscitation (NFR) discourses |
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Year |
2002 |
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Abbreviated Journal |
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Pages |
317 pp |
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Keywords |
Clinical decision making; Attitude of health personnel; Hospitals; Terminal care |
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Abstract |
This study investigates the way that medical, nursing and institutional discourses construct knowledge in the specific context of Not-for-resuscitation (NFR)in a New Zealand general hospital where NFR guidelines are available in the wards and from the regional ethics committee. The thesis argues that there are ranges of techniques that staff use to construct NFR knowledge, enacted through various forms of speech and silence, which result in orderly and disorderly experiences for patients nearing death. The study was conducted through a critical analysis of the talk of health professionals and the Chairperson of the Regional Ethics Committee. |
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Call Number |
NRSNZNO @ research @ |
Serial |
1117 |
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Author |
Mitchell, M.H. |
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Title |
Clinical decision-making processes in emergency nursing |
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Year |
2005 |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Pages |
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Keywords |
Emergency nursing; Education; Clinical decision making |
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Abstract |
The aim of this research paper is to explore the processes of clinical decision-making in relation to emergency nurses and to examine the educational requirements for the development of clinical decision-making skills. Clinical decision-making is foundational to professional nursing practice. It is the expectation of the profession and the organisations in which nurses work that appropriate clinical decision-making will occur. Patients also rightly expect, when being cared for by nurses, that the clinical decisions pertaining to their care will be optimal. |
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Call Number |
NRSNZNO @ research @ 592 |
Serial |
578 |
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Author |
Pirret, A.M. |
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Title |
The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making |
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Year |
2005 |
Publication |
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Abbreviated Journal |
Massey University Library |
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Issue |
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Pages |
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Keywords |
Intensive care nursing; Clinical decision making |
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Abstract |
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Call Number |
NRSNZNO @ research @ 686 |
Serial |
672 |
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Author |
Bunn, S. |
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Title |
An exploration of the transition of patients from intensive care to the ward environment: A ward nursing perspective |
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Year |
2007 |
Publication |
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Abbreviated Journal |
Victoria University of Wellington Library |
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Issue |
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Pages |
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Keywords |
Clinical decision making; Nursing; Communication |
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Abstract |
The transition of patients from intensive care to the ward environment is a regular occurrence in intensive care. Today patients are often transferred earlier and sicker due to the demands for intensive care beds. This results in patients with higher acuity being cared for in the wards. Here ward nurses have to meet the ongoing complex demands of caring for higher acuity patients, alongside managing high patient-to-nurse ratios, staffing concerns, and varying levels of experienced nurses. This research explored the experiences of ward nurses receiving patients transferred from intensive care. The aims were to identify any areas of concern, highlight specific problems that occur on transition and to address what information is pertinent to ward nurses when receiving patients from intensive care. A qualitative descriptive methodology using focus groups was utilised to gather information about these experiences. Three focus groups were held with ward nurses from various wards within the study setting hospital. All participants had considerable contact with intensive care and were familiar with the processes of transferring patients. Five themes emerged from the focus groups – Patients as intensive care staff say they are; Time to prepare the biggest thing; Documentation as a continuation of patient care; They forget what its like; and Families, a need to know about them. The theme Patients as intensive care staff say they are relates to reliable information sharing focused on the patient, their needs and condition. Participants expressed their concern that patients were not always in the condition that the intensive care staff stated they were on the referral. Having adequate time to prepare was considered important for the majority of ward nurses receiving patients from intensive care. Documentation was highlighted in the theme Documentation as a continuation of patient care particularly in relation to fluid balances and vital sign history. The theme They forget what its like suggests there is a perception that intensive care nurses have a lack of understanding of what the ward staff can actually manage. Decreased staffing levels during certain shift patterns and a lack of appropriately experienced staff on the wards is a common concern for ward nurses. Ward nurses also recognised that caring for families was part of their role. Patients and families may respond differently to the transfer process and their inclusion in transfer planning was seen as essential. Communication was a reoccurring element throughout all themes.The author concludes that communication is the paramount factor that impacts on a 'smooth transition' for ward nurses. A 'smooth transition' refers to the transfer of patients from intensive care to the next level of care. Subsequently, nurses' perceptions need to change, whereby transfer planning from ICU should be the focus rather than discharge planning. Transfer planning and education for all nursing staff is vital if the transfer process is to be improved. Consequently, transitional care within the context of ICU aims to ensure minimal disruption and optimal continuity of care for the patient. The knowledge gained from this research may provide better understanding of the multifaceted issues linked with transitional care that may be adapted for a wider range of patients in various clinical environments. |
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Call Number |
NRSNZNO @ research @ 827 |
Serial |
811 |
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