Undergraduate nursing students' peformance in recognising and responding to sudden patient deterioration in high psychological fidelity simulated environments: Quantitative results from an Australian multi-centre study
- Authors: Bogossian, Fiona , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Porter, Joanne , Kain, Victoria , Bucknall, Tracey , Phillips, Nicole
- Date: 2014
- Type: Text , Journal article
- Relation: Nurse Education Today Vol. 34, no. 5 (2014), p. 691-696
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- Description: Objectives This paper reports the quantitative findings of the first phase of a larger program of ongoing research: Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACTTM). It specifically aims to identify the characteristics that may predict primary outcome measures of clinical performance, teamwork and situation awareness in the management of deteriorating patients. Design Mixed-method multi-centre study. Setting High fidelity simulated acute clinical environment in three Australian universities. Participants A convenience sample of 97 final year nursing students enrolled in an undergraduate Bachelor of Nursing or combined Bachelor of Nursing degree were included in the study. Method In groups of three, participants proceeded through three phases: (i) pre-briefing and completion of a multi-choice question test, (ii) three video-recorded simulated clinical scenarios where actors substituted real patients with deteriorating conditions, and (iii) post-scenario debriefing. Clinical performance, teamwork and situation awareness were evaluated, using a validated standard checklist (OSCE), Team Emergency Assessment Measure (TEAM) score sheet and Situation Awareness Global Assessment Technique (SAGAT). A Modified Angoff technique was used to establish cut points for clinical performance. Results Student teams engaged in 97 simulation experiences across the three scenarios and achieved a level of clinical performance consistent with the experts' identified pass level point in only 9 (1%) of the simulation experiences. Knowledge was significantly associated with overall teamwork (p = .034), overall situation awareness (p = .05) and clinical performance in two of the three scenarios (p = .032 cardiac and p = .006 shock). Situation awareness scores of scenario team leaders were low overall, with an average total score of 41%. Conclusions Final year undergraduate nursing students may have difficulty recognising and responding appropriately to patient deterioration. Improving pre-requisite knowledge, rehearsal of first response and team management strategies need to be a key component of undergraduate nursing students' education and ought to specifically address clinical performance, teamwork and situation awareness.
Profiling nurse practitioner practice patterns at a major urban acute health service
- Authors: Lowe, Grainne , Jennings, Natasha , Tregaskis, Peter , Kenneally, Anne , Bucknall, Tracey
- Date: 2018
- Type: Text , Journal article
- Relation: Collegian Vol. 25, no. 3 (2018), p. 277-283
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- Description: Background: Research detailing the practice patterns and services provided by nurse practitioners within a large health care facility is currently lacking in the literature. This study fills a gap in the literature by reporting on the practices of nurse practitioners in a variety of clinical specialty areas within the one health care setting. Aim: To identify the practices of nurse practitioners in different contexts across one health service. BackgroundAn expanding cohort of nurse practitioners within an Australian health service increasingly delivers services to more complex patients. Understanding this phenomenon assists future workforce planning. Methods: An exploratory survey of nurse practitioner practice patterns in a metropolitan health service was conducted. Nurse practitioners electronically entered data from patient encounters for two weeks. Descriptive analysis of the quantitative data was conducted. Results: Nine nurse practitioner specialties were identified and 341 encounters were analysed. All specialty groups included counselling and education in patient management. The use of nurse practitioner extensions to practice was dependent on the specialty area including prescribing medicines. Conclusions: Nurse practitioner scope of practice differs across specialties and is determined by patient cohorts and associated diagnoses. The results highlighted the diversity and depth of services provided by nurse practitioners. Understanding the scope of practice assist with future nurse practitioner role development andimplementation. © 2017 Australian College of Nursing Ltd