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Author (up) Pirret, A.M.
Title The level of knowledge of respiratory physiology articulated by intensive care nurses to provide rationale for their clinical decision-making Type Journal Article
Year 2007 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 23 Issue 3 Pages 145-155
Keywords Evaluation; Intensive care nursing; Clinical decision making; Nursing; Education
Abstract The objective of this paper is to outline a study firstly, assessing ICU nurses' ability in articulating respiratory physiology to provide rationale for their clinical decision-making and secondly, the barriers that limit the articulation of this knowledge. Using an evaluation methodology, multiple methods were employed to collect data from 27 ICU nurses who had completed an ICU education programme and were working in one of two tertiary ICUs in New Zealand. Quantitative analysis showed that nurses articulated a low to medium level of knowledge of respiratory physiology. Thematic analysis identified the barriers limiting this use of respiratory physiology as being inadequate coverage of concepts in some ICU programmes; limited discussion of concepts in clinical practice; lack of clinical support; lack of individual professional responsibility; nurses' high reliance on intuitive knowledge; lack of collaborative practice; availability of medical expertise; and the limitations of clinical guidelines and protocols. These issues need to be addressed if nurses' articulation of respiratory physiology to provide rationale for their clinical decision-making is to be improved.
Call Number NRSNZNO @ research @ Serial 933
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Author (up) Pirret, A.M.
Title The use of knowledge of respiratory physiology in critical care nurses' clinical decision-making Type
Year 2005 Publication Abbreviated Journal Massey University Library
Volume Issue Pages
Keywords Intensive care nursing; Clinical decision making
Abstract
Call Number NRSNZNO @ research @ 686 Serial 672
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Author (up) Pirret, A.M.
Title A preoperative scoring system to identify patients requiring postoperative high dependency care Type Journal Article
Year 2003 Publication Intensive & Critical Care Nursing Abbreviated Journal
Volume 19 Issue 5 Pages 267-275
Keywords Hospitals; Quality of health care; Surgery; Nursing; Clinical assessment
Abstract The incidence of postoperative complications is reduced with early identification of at risk patients and improved postoperative monitoring. This study describes the development and effect of a nursing preoperative assessment tool to identify patients at risk of postoperative complications and to reduce the number of acute admissions to ICU/HDU. All surgical patients admitted to a surgical ward for an elective surgical procedure (n=7832) over a 23-month period were concurrently scored on admission using the preoperative assessment tool. During the time period studied, acute admissions to ICU/HDU reduced from 40.37 to 19.11%. Only 24.04% of patients who had a PAS >4 were identified by the surgeon and/or anesthetist as being at risk of a postoperative complication, or if identified, no provision was made for improved postoperative monitoring. This study supports the involvement of nurses in identifying preoperatively patients at risk of a postoperative complication and in need of improved postoperative monitoring. The postoperative monitoring requirements for the PAS >4 patients were relatively low technology interventions.
Call Number NRSNZNO @ research @ 904 Serial 888
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