- Title
- Managing the deteriorating patient in a simulated environment: Nursing students' knowledge , skill, and situation awareness
- Creator
- Cooper, Simon J.; Kinsman, Leigh; Buykx, Penny; McConnell-Henry, Tracy; Endacott, Ruth; Scholes, Julie
- Date
- 2009
- Type
- Text; Journal article
- Identifier
- http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/97426
- Identifier
- vital:10216
- Identifier
-
https://doi.org/10.1111/j.1365-2702.2009.03164.x
- Identifier
- ISSN:1365-2702
- Abstract
- Abstract AIM: To examine, in a simulated environment, the ability of final-year nursing students to assess, identify and respond to patients either deteriorating or at risk of deterioration. BACKGROUND: The early identification and management of patient deterioration has a major impact on patient outcomes. 'Failure to rescue' is of international concern, with significant concerns over nurses' ability to detect deterioration, the reasons for which are unknown. DESIGN: Mixed methods incorporating quantitative measures of performance (knowledge, skill and situation awareness) and, to be reported at a later date, a qualitative reflective review of decision processes. METHODS: Fifty-one final-year, final-semester student nurses attended a simulation laboratory. Students completed a knowledge questionnaire and two video-recorded simulated scenarios (mannequin based) to assess skill performance. The scenarios simulated deteriorating patients with hypovolaemic and septic shock. Situation awareness was measured by randomly stopping each scenario and asking a series of questions relating to the situation. RESULTS: The mean knowledge score was 74% (range 46-100%) and the mean skill performance score across both scenarios was 60% (range 30-78%). Skill performance improved significantly (p < 0.01) by the second scenario. However, skill performance declined significantly in both scenarios as the patient's condition deteriorated (hypovolaemia scenario: p = 0.012, septic scenario: p = 0.000). The mean situation awareness score across both scenarios was 59% (range 38-82%). Participants tended to identify physiological indicators of deterioration (77%) but had low comprehension scores (44%). CONCLUSION: Knowledge scores suggest, on average, a satisfactory academic preparation, but this study identified significant deficits in students' ability to manage patient deterioration. RELEVANCE TO CLINICAL PRACTICE: This study suggests that student nurses, at the point of qualification, may be inadequately prepared to identify and manage deteriorating patients in the clinical setting.
- Relation
- Journal of Clinical Nursing Vol. 19, no. 15 (2009), p. 2309-2318
- Rights
- Copyright Wiley
- Rights
- This metadata is freely available under a CCO license
- Subject
- Decision-making; Education; Patient deterioration; Simulation; Situation awareness; 1110 Nursing; 1701 Psychology
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