Navigating Uncertainty in Respiratory Assessment: The Interaction of Culture and Technology During Phase I Postanesthetic Recovery

Shannon, Helen E.; Holmes, Cheryl L.; Rush, Kathy L.; Pesut, Barbara

doi:10.1016/j.jopan.2020.04.004

Cited by 2 publications

(9 citation statements)

References 39 publications

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“…Studies originated from Sweden (n = 2), Canada (n = 1) and South Korea (n = 1). Clinical settings are general, 25 orthopedic 26 and surgical 27,28 caring for adult patients in the PACU.…”

Section: Resultsmentioning

confidence: 99%

“…Nurses were recruited from midsized hospitals 25 and from major public hospitals 26,27,28 • databases (n = 248)…”

Section: Resultsmentioning

confidence: 99%

“…27 The ethical issue is due to the di culty in navigating through a more intuitive nursing practice. 25 In 'feelings of uncertainty related to lack of nursing knowledge as scientific uncertainty' associated with diagnosis issues, nurses rationalised their mistrust in technology based on their personal beliefs about what clinical data readings are acceptable 25 and reported insecurity related to scientific knowledge deficit 27 and di erences in practice related to clinical experience. 28 In the prognosis issue, nurses revealed di culties in predicting patients' unexpected reactions to the anaesthesia and preventing adverse events.…”

Section: Shannon Et Al (2020) 25mentioning

confidence: 99%

“…28 In 'clinical (in)experience to deal with uncertainty as practical uncertainty' related to structure of care, nurses adapted their evaluation priorities to the anaesthetist's preferences. 25 In processes of care, nurses reported feeling confused when there is variability in individual anaesthesia handover practises 25 (especially when they contradict evidencebased practises) and refer to peer counselling for evidence-based practice when di cult situations arise. 28 In the system's issues, nurses reinforce the need for clinical practice guidelines adapted to particular situations.…”

Section: Shannon Et Al (2020) 25mentioning

confidence: 99%

“…35 As we move towards more complex patient problems, we increasingly recognise the importance of non-analytical but integrative parts of clinical reasoning by recognising patterns and using clinical intuition. [25][26][27]36 Analytical and non-analytical reasoning 37 can operate separately but are mainly interconnected in clinical practice; to illustrate the complexitybased approach, the application of systemic thinking can benefit the understanding of clinical reasoning. 36 If, on one hand, nurses demonstrate confidence in their professional practice, on the other hand they demonstrate di culties in articulating a subconscious and intuitive assessment approach.…”

Section: Nurses' Intuition To Reason As a Personal Uncertaintymentioning

confidence: 99%

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Uncertainty in post-anaesthesia nursing clinical reasoning: An integrative review in the light of the model of uncertainty in complex health care settings

Cunha¹,

Pestana-Santos²,

Lomba³

et al. 2022

Journal of Perioperative Nursing

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Problem identification: Post-anaesthesia nursing plays an important role in the early detection and treatment of clinical deterioration a ter surgery and/or anaesthesia. Concomitantly, the e ectiveness of post-operative care is highly dependent on the accurate analysis, synthesis of patient data and quality of diagnostic decisions through clinical reasoning. Given the dynamic processes required to come to a diagnosis, uncertainty is common in clinical reasoning and expected during practice. Nevertheless, uncertainty may permeate the foundations of clinical reasoning, which can jeopardise diagnostic accuracy and consequently the quality and safety of health care.Literature search: The objectives of this review are to identify available evidence related to uncertainty in post-anaesthesia nursing clinical reasoning and to analyse the results from the perspective of the Model of Uncertainty in Complex Healthcare Settings (MUCH-S). A comprehensive search strategy using CINAHL (EBSCO), Cochrane Library (EBSCO), Medline (PubMed), ProQuest and Google Scholar databases was used to find published and unpublished relevant studies. Studies published in English and Portuguese were included. There was no temporal restriction, nor geographical or cultural limitation for the studies included.Data evaluation synthesis: All papers were reviewed by the authors to extract key information about purpose, sample and setting, research design and method, key findings and limitations. The literature search identified a total of 248 studies, 22 of which were retrieved for full reading. A total of four articles were included in this review.Implications for practice: Three main themes were identified: nurses' intuition to reason, feelings of uncertainty related to lack of nursing knowledge and clinical (in)experience to deal with uncertainty. These findings are encompassed within the MUCH-S taxonomy: personal, scientific and practical. This review o ers post-anaesthesia nurses' greater levels of understanding of this phenomenon and may support more informed and reflexive clinical reasoning.

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“…Studies originated from Sweden (n = 2), Canada (n = 1) and South Korea (n = 1). Clinical settings are general, 25 orthopedic 26 and surgical 27,28 caring for adult patients in the PACU.…”

Section: Resultsmentioning

confidence: 99%

“…Nurses were recruited from midsized hospitals 25 and from major public hospitals 26,27,28 • databases (n = 248)…”

Section: Resultsmentioning

confidence: 99%

Section: Shannon Et Al (2020) 25mentioning

confidence: 99%

Section: Shannon Et Al (2020) 25mentioning

confidence: 99%

Section: Nurses' Intuition To Reason As a Personal Uncertaintymentioning

confidence: 99%

See 3 more Smart Citations

Uncertainty in post-anaesthesia nursing clinical reasoning: An integrative review in the light of the model of uncertainty in complex health care settings

Cunha¹,

Pestana-Santos²,

Lomba³

et al. 2022

Journal of Perioperative Nursing

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Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study

Peng,

Zang,

Liu

et al. 2024

Journal of Advanced Nursing

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AimTo construct a nursing assessment framework for patients in anaesthesia recovery period.DesignA three‐round modified Delphi method was employed to capture the consensus of 22 panellists.MethodsThe initial items in the nursing assessment framework for patients in anaesthesia recovery period were developed based on the mini‐clinical evaluation exercise (mini‐CEX). A panel of 22 experts participated in this study. The panellists have more than 10 years of experience in either clinical anaesthesia, or post‐anesthesia nursing, or operating room nursing, or surgical intensive nursing. Between March and April 2023, the panellists evaluated and recommended revisions to the initial framework.ResultsThis study resulted in the development of a nursing assessment framework for patients in anaesthesia recovery period. The initial version of the framework consisted of six dimensions with 27 items. Six items were modified after the first round of consultation. After the second round, five modifications and four deletions were made based on expert opinion. The third round resulted in a convergence of expert opinion. The framework, which consists of 24 items across five dimensions, was refined. The five dimensions are as follows: History‐taking, Physical assessment, Clinical judgement, Organizational efficiency and Humanistic concern.ConclusionThe nursing assessment framework for patients in anaesthesia recovery period was reached consensus between the 22 experts’ opinions.Implications for the profession and patient careThe assessment framework constructed in this study could be used for the process evaluation of post‐anesthesia nursing. The framework may guide perianesthesia nurses in the timely and effective assessment of patients during this critical phase of care. It may be used for perianesthesia nursing education or to evaluate nurses' assessment skills.Reporting methodThe study is reported in accordance with the Guidance on Conducting and Reporting DElphi Studies (CREDES) recommendations.Patient or public contributionNo patient or public contribution.

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Navigating Uncertainty in Respiratory Assessment: The Interaction of Culture and Technology During Phase I Postanesthetic Recovery

Cited by 2 publications

References 39 publications

Uncertainty in post-anaesthesia nursing clinical reasoning: An integrative review in the light of the model of uncertainty in complex health care settings

Uncertainty in post-anaesthesia nursing clinical reasoning: An integrative review in the light of the model of uncertainty in complex health care settings

Construction of a nursing assessment framework for patients in anaesthesia recovery period: A modified Delphi study

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