Managing women with acute physiological deterioration: Student midwives performance in a simulated setting

Cooper, Simon; Bulle, Bree; Biró, Mary Anne; Jones, Janet; Miles, Matthew; Gilmour, Carole Jane; Buykx, Penny; Boland, Rosemarie A; Kinsman, Leigh; Scholes, Julie; Endacott, Ruth

doi:10.1016/j.wombi.2011.08.009

Cited by 30 publications

(35 citation statements)

References 52 publications

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“…Our research questions aimed to identify how nurses manage deteriorating patients in relation to the application of knowledge, situation awareness and leadership ability. As in our previous studies,13 14 18 knowledge levels were reasonable but with younger less experienced nurses achieving higher scores. Furthermore, based on the same MCQ, we identified from earlier data13 that nursing students at the point of completion (n=43) achieved significantly higher scores than the qualified staff in this study (t(93)=3.966, df 91, p<0.001, CI 5.401 to 16.236).…”

Section: Discussionsupporting

confidence: 84%

“…This has been the foundation for a number of studies which identified that nurse participants had reasonable theoretical knowledge but failed to respond appropriately to simulated deteriorating patients 13 17 18. For example, as patients deteriorated and anxiety levels increased, performance and awareness of the situation significantly reduced.…”

Section: Introductionmentioning

confidence: 99%

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Managing patient deterioration: assessing teamwork and individual performance

et al. 2012

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Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Managing patient deterioration: assessing teamwork and individual performance

et al. 2012

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“…Standardised patient actors will be employed to simulate these presenting conditions to enhance the reality of the simulation. These team based scenarios (for groups of three learners, covering 5 groups a day) have been developed from previous work [16-18] and include nominal yes/no ratings of performance that will be rated and verified by two clinicians.…”

Section: Design/methodsmentioning

confidence: 99%

“…In health care contemporary education approaches emphasise the need for active learning [11] and increased use of simulated environments [12-15] to reduce medical errors [14] in settings with high technological, environmental and psychological fidelity [15]. Since 2008 in pilot work with individual nursing students [16,17], midwifery students [18] and Registered nurses working in a hospital setting [19] we have examined patient management in simulated settings using an interventional program known as FIRST 2 ACT ( Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends ). It was found that participants had good theoretical knowledge but that they often failed to respond appropriately.…”

Section: Introductionmentioning

confidence: 99%

Managing patient deterioration: a protocol for enhancing undergraduate nursing students’ competence through web-based simulation and feedback techniques

Cooper¹,

Beauchamp

Bogossian

et al. 2012

BMC Nurs

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AimsTo describe a funded proposal for the development of an on-line evidence based educational program for the management of deteriorating patients.BackgroundThere are international concerns regarding the management of deteriorating patients with issues around the ‘failure to rescue’. The primary response to these issues has been the development of medical emergency teams with little focus on the education of primary first responders.Design/MethodsA mixed methods triangulated convergent design.In this four phase proposal we plan to 1. examine nursing student team ability to manage deteriorating patients and based upon these findings 2. develop web based educational material, including interactive scenarios. This educational material will be tested and refined in the third Phase 3, prior to evaluation and dissemination in the final phase.ConclusionThis project aims to enhance knowledge development for the management of deteriorating patients through rigorous assessment of team performance and to produce a contemporary evidence-based online training program.

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“…Cue perception refers to the ability to perceive subtle changes in patient physiological parameters. In prior studies examining student and registered nurses’ (RN) ability to identify and mange simulated clinical deterioration, nurses were found to have poor situation awareness (SA) (Cooper et al, , ; McKenna et al, ). They missed both subtle and overt patient cues indicating clinical deterioration.…”

Section: Introductionmentioning

confidence: 99%

Perception of clinical deterioration cues among medical‐surgical nurses

Orique

Despins

Wakefield

et al. 2019

Journal of Advanced Nursing

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Aim To examine medical‐surgical nurses’ capacity and tendency to perceive cues indicating clinical deterioration and nursing characteristics influencing deterioration cue perception. Design Cross‐sectional, explorative study design. Methods Data were collected over 10 weeks between September–November 2017. Medical‐surgical nurses completed an online survey consisting of a demographic questionnaire, the Occupational Fatigue, Exhaustion Recovery scale and 50 detection trials. Descriptive statistics and statistical tests were used to describe and interpret data. Findings A significant association was found between nurses’ capacity and tendency to perceive deterioration cues. As nurses’ capacity to perceive deterioration cues increased, nurses were more likely to classify patient cues as indicators of deterioration. Fatigue, education, and certification were not identified as characteristics associated with deterioration cue perception. However, experience was observed to significantly influence nurses’ capacity to perceive deterioration cues based on levels of skills acquisition. Conclusion Study findings imply that future research should be directed at determining whether other individual factors and organizational system dynamics influence deterioration cue perception. Impact To better understand how nurses perceive deterioration cues, this study integrated concepts from the Situation Awareness model and Signal Detection Theory. Novice, advanced beginner and competent nurses were found to have a lower capacity to perceive deterioration cues compared with proficient and expert nurses. With simulation increasingly being used as a primary teaching modality in nursing, the development of a simulation‐based signal detection training intervention may be beneficial in enhancing deterioration cue perception.

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Managing women with acute physiological deterioration: Student midwives performance in a simulated setting

Cited by 30 publications

References 52 publications

Managing patient deterioration: assessing teamwork and individual performance

Managing patient deterioration: assessing teamwork and individual performance

Managing patient deterioration: a protocol for enhancing undergraduate nursing students’ competence through web-based simulation and feedback techniques

Perception of clinical deterioration cues among medical‐surgical nurses

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