List of Titles

Families' needs of critical care Muslim patients in Saudi Arabia : A quantitative study

- Al Mutair, Abbas, Plummer, Virginia, Clerehan, Rosemary, O'Brien, Anthony

Authors: Al Mutair, Abbas , Plummer, Virginia , Clerehan, Rosemary , O'Brien, Anthony
Date: 2014
Type: Text , Journal article
Relation: Nursing in Critical Care Vol. 19, no. 4 (2014), p. 185-195
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Description: Aim: To identify the needs of families of adult intensive care unit (ICU) patients in Saudi Arabia as perceived by family members and health care providers. Background: Family members of critically ill patients are likely to have specific needs that should be addressed by the critical care team and which, if unmet, may produce stress for patients' families and health care providers. The literature has yet to identify the needs of Muslim families in relation to religious beliefs and cultural values in critical care settings in Saudi Arabia. Design: A cross-sectional survey design. Method: A total of 176 family members and 497 intensive health care providers were recruited from eight adult mixed medical-surgical ICUs between November 2011 and February 2012 utilizing a four-point Likert type scale self-administered questionnaire. Results: The findings revealed that family members and health care providers ranked assurance, information and cultural and spiritual needs as the most important, and support and proximity as least important. There were significant differences in the mean values found between family members and health care providers. A significant finding not identified in other studies was 'The need to have the health care providers handle the body of the dead Muslim with extreme caution and respect' which, under the dimension of cultural and spiritual needs, was perceived by family members to be the most important and by the health care providers as the fifth most important need. Conclusion: The recognition of family needs in the critical care unit informed the development of interventions to meet family needs and improve the care quality. © 2013 British Association of Critical Care Nurses.

Family presence during resuscitation : A descriptive study of nurses' attitudes from two Saudi hospitals

- Al Mutair, Abbas, Plummer, Virginia, Copnell, Beverley

Authors: Al Mutair, Abbas , Plummer, Virginia , Copnell, Beverley
Date: 2012
Type: Text , Journal article
Relation: Nursing in Critical Care Vol. 17, no. 2 (2012), p. 90-98
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Description: Background: The presence of family in the patient care area during resuscitation events is a matter of current debate among health care professionals in many communities. Family presence is highly recommended by many health organizations worldwide for several reasons including patient and family rights. There are no policies or guidelines in Saudi Arabia to guide health professionals in their practice regarding the option of family being present during resuscitations. The purpose of this study was to identify the attitudes of nurses towards family presence during resuscitation in the Muslim community of Saudi Arabia. Design: This is a descriptive survey using data from a convenience sample of 132 nurses using a self-administered questionnaire. The study took place in two major trauma centres in the eastern region of Saudi Arabia. Results: The analysis of the data revealed that nurses (n = 132) had negative attitudes towards family presence during resuscitation. A high percentage (77·2%) agreed that witnessing resuscitation is a traumatic experience for the family members. Almost all participants (92·3%) disagreed with the statement that the practice of allowing family members to be present during the resuscitation of a loved one would benefit the patient and 78% disagreed with the statement that it would benefit families. The majority of the participants (65%) revealed that the presence of family would negatively affect the performance of the resuscitation team. However, almost half of the sample (43·8%) would prefer a written policy allowing the option of family presence during resuscitation in Saudi Arabia. Conclusion: The findings of the study strongly suggest the need for the development of written policies offering families the option to remain with patients during resuscitation in Saudi Arabia. The study further recommends the development of education programs for staff and public for the safe implementation of the practice. © 2012 The Authors. Nursing in Critical Care © 2012 British Association of Critical Care Nurses.

Family needs and involvement in the intensive care unit : A literature review

- Al Mutair, Abbas, Plummer, Virginia, O'Brien, Anthony, Clerehan, Rosemary

Authors: Al Mutair, Abbas , Plummer, Virginia , O'Brien, Anthony , Clerehan, Rosemary
Date: 2013
Type: Text , Journal article , Review
Relation: Journal of Clinical Nursing Vol. 22, no. 13-14 (2013), p. 1805-1817
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Description: Aims and objectives: To understand the needs of critically ill patient families', seeking to meet those needs and explore the process and patterns of involving family members during routine care and resuscitation and other invasive procedures. Methods: A structured literature review using Cumulative Index to Nursing and Allied Health Literature, Pubmed, Proquest, Google scholar, Meditext database and a hand search of critical care journals via identified search terms for relevant articles published between 2000 and 2010. Results: Thirty studies were included in the review either undertaken in the Intensive Care Unit or conducted with critical care staff using different methods of inquiry. The studies were related to family needs; family involvement in routine care; and family involvement during resuscitation and other invasive procedures. The studies revealed that family members ranked both the need for assurance and the need for information as the most important. They also perceived their important needs as being unmet, and identified the nurses as the best staff to meet these needs, followed by the doctors. The studies demonstrate that both family members and healthcare providers have positive attitudes towards family involvement in routine care. However, family members and healthcare providers had significantly different views of family involvement during resuscitation and other invasive procedures. Conclusion: Meeting Intensive Care Unit family needs can be achieved by supporting and involving families in the care of the critically ill family member. More emphasis should be placed on identifying the family needs in relation to the influence of cultural values and religion held by the family members and the organisational climate and culture of the working area in the Intensive Care Unit. © 2013 Blackwell Publishing Ltd.

A new scale for disaster nursing core competencies : Development and psychometric testing

- Al Thobaity, Abdulellah, Williams, Brett, Plummer, Virginia

Authors: Al Thobaity, Abdulellah , Williams, Brett , Plummer, Virginia
Date: 2016
Type: Text , Journal article
Relation: Australasian Emergency Nursing Journal Vol. 19, no. 1 (2016), p. 11-19
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Description: Background: All nurses must have core competencies in preparing for, responding to and recovering from a disaster. In the Kingdom of Saudi Arabia (KSA), as in many other countries, disaster nursing core competencies are not fully understood and lack reliable, validated tools. Thus, it is imperative to develop a scale for exploring disaster nursing core competencies, roles and barriers in the KSA. Objectives: This study's objective is to develop a valid, reliable scale that identifies and explores core competencies of disaster nursing, nurses' roles in disaster management and barriers to developing disaster nursing in the KSA. Methods: This study developed a new scale testing its validity and reliability. A principal component analysis (PCA) was used to develop and test psychometric properties of the new scale. The PCA used a purposive sample of nurses from emergency departments in two hospitals in the KSA. Participants rated 93 paper-based, self-report questionnaire items from 1 to 10 on a Likert scale. PCA using Varimax rotation was conducted to explore factors emerging from responses. Findings: The study's participants were 132 nurses (66% response rate). PCA of the 93 questionnaire items revealed 49 redundant items (which were deleted) and 3 factors with eigenvalues of >1. The remaining 44 items accounted for 77.3% of the total variance. The overall Cronbach's alpha was 0.96 for all factors: 0.98 for Factor 1, 0.92 for Factor 2 and 0.86 for Factor 3. Conclusions: This study provided a validated, reliable scale for exploring nurses' core competencies, nurses' roles and barriers to developing disaster nursing in the KSA. The new scale has many implications, such as for improving education, planning and curricula. © 2015.

Perceptions of knowledge of disaster management among military and civilian nurses in Saudi Arabia

- Al Thobaity, Abdulellah, Plummer, Virginia, Innes, Kelli, Copnell, Beverley

Authors: Al Thobaity, Abdulellah , Plummer, Virginia , Innes, Kelli , Copnell, Beverley
Date: 2015
Type: Text , Journal article
Relation: Australasian Emergency Nursing Journal Vol. 18, no. 3 (2015), p. 156-164
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Description: Summary Background It is generally accepted that nurses have insufficient knowledge about disaster preparedness due to a lack of acceptance of core competencies and the absence of disaster preparedness in nursing curricula.1 This study explored nurses’ knowledge and sources of knowledge, and skills as they relate to disaster management in Saudi Arabia, where more than 4660 people have died, 32,000 people have been affected, and US$4.65 billion in damage has been caused by disaster since 1980.2 Methods A quantitative, non-experimental, descriptive research design. Results Nurses in Saudi Arabia have moderate knowledge concerning disaster preparedness. However, nurses in military hospitals possess more knowledge than those who work in government hospitals. The majority of nurses gained their knowledge and skills from disaster drills. Conclusions Nurses need more education in all areas of disaster management, most importantly in their roles during response to disasters. Nurses perceive themselves as not well-prepared but they are willing to improve their skills in disaster preparedness if educational opportunities are provided.

Performance evaluation of multipath cellular networks in obstacle mobility model for downlink packet video communication

- Al Yusuf, Abdullah, Murshed, Manzur

Authors: Al Yusuf, Abdullah , Murshed, Manzur
Date: 2008
Type: Text , Conference paper
Relation: 2008 IEEE 68th Vehicular Technology Conference p. 1-5
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Description: Obstacles present in the line of sight transmission path of a wireless signal severely attenuates the received signal power. Extreme fluctuations of the received signal power caused by shadowing can create "blind spots". Blind spots are areas within the cellular coverage area from where no communication is possible to the base station (BS). For single path packet based services link failures results in total loss of communication. The problem of link failure and blind spots can almost be eliminated in the recently proposed multipath cellular architecture (MCA) which provisions up to three different communication links from the mobile node (MN) to three adjacent BSs through overlapped coverage. Voice and/or multimedia packet delivery can thus benefit by establishing communication from the best interface in terms of received signal power. In this paper, we evaluate the performance of the multi-path MCA model in reducing link failure and blind spot communication problems in presence of multiple obstacles and shadow fading. Obstacle mobility model is utilized as the preferred user mobility model. Video transmission performance improves significantly in terms of reduced packet loss and improved reproduced signal quality at the receiver for the multipath MCA model compared to the existing single path cellular network architecture

Improving the security in healthcare information system through elman neural network based classifier

- Al-Dhafian, Buthina, Ahmad, Iftikhar, Hussain, Muhammad, E. Amin, Fazal, Imran, Muhammad

Authors: Al-Dhafian, Buthina , Ahmad, Iftikhar , Hussain, Muhammad , E. Amin, Fazal , Imran, Muhammad
Date: 2017
Type: Text , Journal article
Relation: Journal of Medical Imaging and Health Informatics Vol. 7, no. 6 (2017), p. 1429-1435
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Description: Intrusions are critical issues in information system of healthcare sector because a sole intrusion can cause health issue due to any manipulation in the medical record of the patients. Several intrusion detection (ID) techniques have been used but their performance is the dilemma. The efficiency of intrusion detection systems (IDSs) depends on optimal classifier architecture to categorize the data into intrusive or normal, which required increasing detection rates (DR) and decreasing false alarm rates (FAR). Therefore, to find an optimal classifier architecture to enhance performance in IDSs is an important subject. This study proposed Elman Neural Network-based IDS as classification technique in order to enhance performance. NSL-KDD Dataset is used for evaluation and assessment. Moreover, Principle Component Analysis (PCA) is applied in this work in order to convert raw features to principal space and choose features based on their sensitivity. The proposed approach is capable to enhance performance by increased DR and decreased FAR. © 2017 American Scientific Publishers All rights reserved.

Anxiety and clinical performance in simulated setting in undergraduate health professionals education : An integrative review

- Al-Ghareeb, Amal, Cooper, Simon J., McKenna, Lisa

Authors: Al-Ghareeb, Amal , Cooper, Simon J. , McKenna, Lisa
Date: 2017
Type: Text , Journal article , Review
Relation: Clinical Simulation in Nursing Vol. 13, no. 10 (2017), p. 478-491
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Description: Background Undergraduate health professionals clearly experience anxiety during simulation. However, little is known regarding learners’ physiological and psychological responses and the influence of these responses on performance. Method An integrative review was undertaken to provide a comprehensive understanding of the influence of anxiety on undergraduate health professionals’ performance during simulation, and to review the tools and measurements reported in the healthcare literature. Result Eleven articles were included showing simulation aroused learners physiologically and psychologically, either improving or declining clinical performance. Conclusion Two contrasting perceptions emerged, which are indicative of the current lack of understanding regarding the effects of anxiety on performance in a simulation setting. © 2017 International Nursing Association for Clinical Simulation and Learning

The influence of anxiety on student nurse performance in a simulated clinical setting : A mixed methods design

- Al-Ghareeb, Amal, McKenna, Lisa, Cooper, Simon J.

Authors: Al-Ghareeb, Amal , McKenna, Lisa , Cooper, Simon J.
Date: 2019
Type: Text , Journal article
Relation: International Journal of Nursing Studies Vol. 98, no. (2019), p. 57-66
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Description: Background: Anxiety has a powerful impact on learning due to activation of anxiety hormones, which target related receptors in the working memory. Experiential learning requires some degree of challenge and anxiety. Patient simulation, as a form of experiential learning, has been an integrated component of health professional education internationally over the last two decades, especially in undergraduate nursing education. Little information is available to determine if and how anxiety impacts nursing students’ clinical performance during simulation. Objectives: To investigate physiological and psychological anxiety during emergency scenarios in high-fidelity simulation and understand the effect of anxiety on clinical performance. Design: First2Act was the model for the simulation intervention. Second and third year undergraduate nursing students attended a two-hour simulation session and completed a demographic questionnaire plus pre-simulation self-reported psychological anxiety scale. A heart rate variability monitor was attached to each student's chest to measure heart rate variability (as a sign of anxiety) before engaging in two video-recorded simulated emergency scenarios (cardiac and respiratory) with a professional actor playing the patient. Performance was rated by a clinician followed by video-assisted debriefing. Finally, heart monitors were removed and students repeated self-reports of psychological anxiety. Results: Students’ psychological anxiety was high pre-simulation and remained high post-simulation. With regard to physiological anxiety, students were anxious at the start of the simulation but became more relaxed toward the end as they gained familiarly with the simulation environment (p < .007). Clinical performance increased significantly in the second scenario (p < .001). Factors found to positively affect clinical performance were length of enrolment in the nursing degree (p = .001), current employment in a nursing or allied healthcare field (p = .030), and previous emergency experience (p = .047). The relationship between physiological anxiety and clinical performance was statistically not significant, although there was an indication that low level anxiety led to optimal performance. Conclusion: High-fidelity patient simulation has the capacity to arouse novice nurses psychologically and physiologically while managing emergency situations. Indicative outcomes suggest that optimal performance was apparent when anxiety levels were low, indicating that they had received insufficient training to deal with situations that induced moderate to high anxiety levels.

The preliminary investigation of the factors that influence the E-learning adoption in higher education institutes: Jordan case study

- Al-Hawari, Maen, Al-Halabi, S.

Authors: Al-Hawari, Maen , Al-Halabi, S.
Date: 2010
Type: Text , Journal article
Relation: International Journal of Distance Education Technologies Vol. 8, no. 4 (2010), p. 1-11
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Description: Creativity and high performance in learning processes are the main concerns of educational institutions. E-learning contributes to the creativity and performance of these institutions and reproduces a traditional learning model based primarily on knowledge transfer into more innovative models based on collaborative learning. In this paper, the authors focus on the preliminary investigation of factors that influence e-learning adoption in Jordan. As a pioneer country for e-learning systems in the Middle East, an investigation has been completed for one of Jordan's universities that has implemented e-learning. Factors are defined through the analysis of unstructured interviews with developers and users of the e-learning systems, and Leximancer content analysis software is used to analyze the interview's content. Main factors include Internet, legislations, human factors, and Web content. Copyright Â© 2010, IGI Global.

Pulsed ultrasound as an energy saving mode for ultrasound treatment of surface water with terrestrial aquatic carbon

- Al-Juboori, Raed, Yusaf, Talal, Bowtell, Leslie

Authors: Al-Juboori, Raed , Yusaf, Talal , Bowtell, Leslie
Date: 2018
Type: Text , Journal article
Relation: Desalination and Water Treatment Vol. 135, no. (2018), p. 167-176
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Description: The use of ultrasound technology in water treatment has gained great popularity in recent years owing to its benign environmental effects. The evaluation of this technology for water treatment purposes has mostly been conducted using synthetic water samples. This study however investigated the use of ultrasound for treating natural water with organic carbon predominantly derived from terrestrial sources. Ultrasound treatments were applied in continuous and pulsed modes with a range of On: Off ratios (R) and power intensity of 21.5 W/cm2 for 4 min. Physio-chemical and spectroscopic measurements were applied to determine the effect of ultrasound treatments on the concentration and structure of dissolved organic carbon (DOC) in the treated water. Post-hoc statistical analysis at a significance level of 0.05 showed that the performance of pulsed ultrasound treatments at least at one of pulse settings was better than that of continuous treatment. Overall, it was found that ultrasound treatments decreased DOC in the treated water and altered its nature to become more reactive towards oxidation and electrochemical reactions. Energy and cost analysis for DOC removal have also been conducted and results showed that applying the appropriate pulse settings can reduce the cost of the treatment by more than a half.

Machine learning based biosignals mental stress detection

- Al-Jumaily, Adel, Matin, Nafisa, Hoshyar, Azadeh

Authors: Al-Jumaily, Adel , Matin, Nafisa , Hoshyar, Azadeh
Date: 2021
Type: Text , Conference paper
Relation: 6th International Conference on Soft Computing in Data Science, SCDS 2021 Vol. 1489 CCIS, p. 28-41
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Description: Mental Stress can be defined as a normal physiological and biological reaction to an incident or a situation that makes a person feel challenged, troubled, or helpless. While dealing with stress, some changes occur in the biological function of a person, which results in a considerable change in some bio-signals such as, Electrocardiogram (ECG), Electromyography (EMG), Electrodermal Activity (EDA), respiratory rate. This paper aims to review the effect of mental stress on mental condition and health, the changes in biosignals as an indicator of the stress response and train a model to detect stressed states using the biosignals. This paper delivers a brief review of mental stress and biosignals correlation. It represents four Support Vector Machine (SVM) models trained with ECG and EMG features from an open access database based on task related stress. After performing comparative analysis on the four types of trained SVM models with chosen features, Gaussian Kernel SVM is selected as the best SVM model to detect mental stress which can predict the mental condition of a subject for a stressed and relaxed condition having an accuracy of 93.7%. These models can be investigated further with more biosignals and applied in practice, which will be beneficial for the physician. © 2021, Springer Nature Singapore Pte Ltd.

A coordination polymer for the site-specific integration of semiconducting sequences into DNA-based materials

- Al-Mahamad, Lamia, El-Zubir, Osama, Smith, David, Horrocks, Benjamin, Houlton, Andrew

Authors: Al-Mahamad, Lamia , El-Zubir, Osama , Smith, David , Horrocks, Benjamin , Houlton, Andrew
Date: 2017
Type: Text , Journal article
Relation: Nature Communications Vol. 8, no. 1 (2017), p. 720-27
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Description: Advances in bottom-up material design have been significantly progressed through DNA-based approaches. However, the routine integration of semiconducting properties, particularly long-range electrical conduction, into the basic topological motif of DNA remains challenging. Here, we demonstrate this with a coordination polymer derived from 6-thioguanosine (6-TG-H), a sulfur-containing analog of a natural nucleoside. The complexation reaction with Au(I) ions spontaneously assembles luminescent one-dimensional helical chains, characterized as {Au (μ-6-TG)} , extending many μm in length that are structurally analogous to natural DNA. Uniquely, for such a material, this gold-thiolate can be transformed into a wire-like conducting form by oxidative doping. We also show that this self-assembly reaction is compatible with a 6-TG-modified DNA duplex and provides a straightforward method by which to integrate semiconducting sequences, site-specifically, into the framework of DNA materials, transforming their properties in a fundamental and technologically useful manner.Integration of semiconducting properties into the basic topological motif of DNA remains challenging. Here, the authors show a coordination polymer derived from 6-thioguanosine that complexes with Au(I) ions to form a wire-like material that can also integrate semiconducting sequences into the framework of DNA materials.

Inattentional blindness and pattern-matching failure : The case of failure to recognize clinical cues

- Al-Moteri, Modi, Symmons, Mark, Cooper, Simon J., Plummer, Virginia

Authors: Al-Moteri, Modi , Symmons, Mark , Cooper, Simon J. , Plummer, Virginia
Date: 2018
Type: Text , Journal article
Relation: Applied Ergonomics Vol. 73, no. (2018), p. 174-182
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Description: Eye-tracking methodology was used to investigate lapses in the appropriate treatment of ward patients due to not noticing critical cues of deterioration. Forty nursing participants with different levels of experience participated in an interactive screen-based simulation of hypovolemic shock. The results show that 65% of the participants exhibited at least one episode of non-fixation on clinically relevant, fully visible cues that were in plain sight. Thirty-five percent of participants dwelt for sufficient time (>200 ms) on important cues for perception to take place, but no action followed, indicating they had pattern-matching failure. When participants fail to notice what, they should notice in patient status until it is too late, this can have serious consequences. Much work needs to be done, since these human perceptual limitations can affect patient safety in general wards.

Eye tracking to investigate cue processing in medical decision making : A scoping review

- Al-Moteri, Modi, Symmons, Mark, Plummer, Virginia, Cooper, Simon J.

Authors: Al-Moteri, Modi , Symmons, Mark , Plummer, Virginia , Cooper, Simon J.
Date: 2017
Type: Text , Journal article , Review
Relation: Computers in Human Behavior Vol. 66, no. (2017), p. 52-66
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Description: Eye-tracking techniques have been adopted as a research tool for a wide range of applications in healthcare studies. Recently, healthcare researchers have started to show interest in using eye-tracking techniques to study medical decision-making. Mapping the literature pertaining to eye tracking using a systematic approach is valuable at this point to bring together all the studies to date on how medical decision-makers make decisions, and the results may contribute to clinical training. This review follows Arksey and O'Malley's scoping review framework to improve our understanding of visual cue processing in medical decision-making. A diverse range of studies was identified, and the results are presented descriptively to develop a more coherent understanding of different aspects of cue processing and errors in medical decision-making. The review shows the need for more extensive investigations of cue processing and medical decision-making. Crown Copyright (C) 2016 Published by Elsevier Ltd. All rights reserved.

Rapid visual search games and accuracy of students' clinical observation skills : a comparative study

- Al-Moteri, Modi, Alrehaili, Amani, Plummer, Virginia, Yaseen, Ruba, Alhakami, Reem

Authors: Al-Moteri, Modi , Alrehaili, Amani , Plummer, Virginia , Yaseen, Ruba , Alhakami, Reem
Date: 2021
Type: Text , Journal article
Relation: Clinical Simulation in Nursing Vol. 55, no. (2021), p. 19-26
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Description: Background: Rapid visual search (RVS) games require a player to search for a target against a distracting background. Playing RVS is known to improve observation and related skills for those professions that require ultimate observation skills. Aim: To examine whether using RVS games improves clinical observation of nursing students. Method: Post intervention assessment design was used in which participants were assigned to either RVS group or non-RVS group and their performance was compared to assess the impact of RVS games on students’ observational skills. Finding: Study findings revealed that RVS improved identification of cues that are highly visual in nature and related to liver cirrhosis. This may indicate that the RVS groups were more focused on the clinical markers than were the non-RVS group. © 2021. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Virginia Plummer” is provided in this record**

Nurses' cognitive and perceptual bias in the identification of clinical deterioration cues

- Al-Moteri, Modi, Cooper, Simon J., Symmons, Mark, Plummer, Virginia

Authors: Al-Moteri, Modi , Cooper, Simon J. , Symmons, Mark , Plummer, Virginia
Date: 2020
Type: Text , Journal article
Relation: Australian Critical Care Vol. 33, no. 4 (2020), p. 333-342
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Description: Background: Perception and processing of clinical cues have rarely been investigated in the nursing literature despite their relevance to the early identification and management of clinical deterioration. Aim: This study used a hypovolemic shock scenario from the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACT) virtual simulation program, equipped with an eye tracker, to investigate cue processing during the management of patient deterioration. Result: The study revealed that attention deviation distorted interpretation of subsequent cues, causing 63% of participants to exhibit a cognitive bias (heightened sensitivity to specific but noncritical cues) and 65% to exhibit at least one episode of nonfixation on clinically relevant cues. Attention deviation and distorted interpretations of clinical cues will have an impact on patient safety. Conclusion: The findings are likely to have important implications for understanding error and associated training implications. © 2019 Australian College of Critical Care Nurses Ltd

Clinical deterioration of ward patients in the presence of antecedents : A systematic review and narrative synthesis

- Al-Moteri, Modi, Plummer, Virginia, Cooper, Simon J., Symmons, Mark

Authors: Al-Moteri, Modi , Plummer, Virginia , Cooper, Simon J. , Symmons, Mark
Date: 2019
Type: Text , Journal article , Review
Relation: Australian Critical Care Vol. 32, no. 5 (2019), p. 411-420
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Description: Aim: The aim of this review was to identify and synthesise published accounts of recognising and responding to patient deterioration in the presence of deterioration antecedents. Design: The systematic review canvassed four electronic databases/ search engines for studies of adult ward patients who had altered physiological parameters before developing major adverse events. Synthesis Methods: The findings were synthesised using a narrative approach. Results: Clinical deterioration can be missed by nurses, even with adequate charting. Delays in recognising and responding to patient deterioration remains an international patient safety concern, and strategies to enhance recognition of patient deterioration have not achieved consistent improvements. The lack of significant and sustained improvement through targeted training suggests the problem may be rooted in human behaviour and local ward culture. Nurses play a pivotal role in recognising and responding to patient deterioration; however, patient records do not facilitate tracking of all nurse decisions and actions, and any undocumented care cannot be easily captured by auditing processes. Conclusion: Failure to recognise clinical deterioration was evident even with adequate charting. It is not clear if nurses do not recognise clinical deterioration because they failed to interpret the signs of deterioration or they made a conscious decision not to escalate based on their clinical judgement or they lacked attention at the time of the event. Whatever the reason, focus is warranted for nurses' decisionmaking after the recording of clinical deterioration signs and the role of human factors in delayed recognition, before maximum benefit of any strategy can be achieved.

Decision-making errors during recognizing and responding to clinical deterioration : gaze path-cued retrospective think-aloud

- Al-Moteri, Modi, Plummer, Virginia, Cooper, Simon

Authors: Al-Moteri, Modi , Plummer, Virginia , Cooper, Simon
Date: 2022
Type: Text , Journal article
Relation: Clinical Simulation in Nursing Vol. 73, no. (2022), p. 29-36
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Description: Background: Using individuals. own eye gaze path and mouse click tracks has proven to be a valuable technique for identifying a broad range of underlying cognitive processes and lapses of decision-making. Aim: The study aims to investigate nurses. decision-making errors in clinical deterioration. Method: Tobii eye tracker(R) was used to collect eye movements and mouse clicks of eighteen participants followed by gaze path retrospective interview. Finding: Thematic analysis revealed several forms of cognitive bias including anchoring, availability and confirmation bias, commission error and Yin-yang out. A distraction effect was apparent in nurses' ability to perceive, process data and to intervene. © 2022

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