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- W3080772321 abstract "Introduction: The physiological determinants of clinical deterioration are well documented. Less focus however, has been on the role healthcare systems and processes may play in the development of clinical deterioration. Objectives/Aims: To explore acute care nurses’ perceptions of factors that contribute to clinical deterioration culminating in a MET review. Methods: Following ethics approval an exploratory, descriptive study using semi-structured interviews was conducted in a university affiliated hospital (560 bed) in Melbourne, Australia. Registered nurses were recruited using purposive sampling for appointment, incumbency and recent experiences of recognising and responding to clinical deterioration. Participants provided demographic data before individual interviews which were audio recorded and transcribed verbatim. Transcripts were analysed using the Framework Method and rigor achieved using regular researcher reflection and peer-debriefing. Results: Twenty-one nurses from four acute care wards consented to participate. Most (n=20) were female, aged 25-34 years (n=12), appointed as registered nurses’ grade 2 (n=16) and were Bachelor qualified (n=20). Participants had between 3 to 30 years’ experience as Registered Nurses. Interview analysis revealed three themes. The Patient Complexity Continuum described patient characteristics that increased the complexity of patient care. Shared Decision-Making Inertia described a vicious cycle in which complex care needs inhibited communication and shared decision-making. Wrong Place, Wrong Time described the impact of factors such as staff rostering and patient location on clinical deterioration. All three themes revealed experiences that participants associated with an increased risk of clinical deterioration for patients. Participants described using their clinical and organisational expertise to manipulate systems and processes to enhance patient outcomes. Conclusion: Clinical deterioration resulted from a complex interplay between patient, clinician and system factors. Experienced nurses actively manipulated healthcare systems and processes to ensure patient needs were met and prevent clinical deterioration." @default.
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- W3080772321 date "2020-01-01" @default.
- W3080772321 modified "2023-09-26" @default.
- W3080772321 title "Registered nurses perceptions of factors contributing to clinical deterioration in an acute care hospital" @default.
- W3080772321 doi "https://doi.org/10.1016/j.aucc.2020.04.024" @default.
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