Technology versus Clinical Evaluation for Fluid Management Decisions in CABG Patients

Pierson, M; Funk, Marjorie

doi:10.1111/j.1547-5069.1989.tb00141.x

Cited by 5 publications

(2 citation statements)

References 16 publications

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“…Clinical judgment and decision making in experienced nurses are related to complex knowledge and the ability to respond to rapidly changing cues in an uncertain environment (Hughes & Young, 1992;Jenny & Logan, 1992;Pierson & Funk, 1989;Verran & Reid, 1987). Masters and Masters (1989) assert that all decisions involve risk and found that nursing decisions are influenced by a person's propensity for taking risks.…”

Section: Conceptual Backgroundmentioning

confidence: 99%

Acknowledging Intuition in Clinical Decision Making

Rew

2000

J Holist Nurs

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The purpose of this study was to develop and validate a scale to measure nurses' acknowledgment of using intuition in clinical decision making. Development and validation of the scale was carried out in three phases. In Phase 1, scale items were generated from the published literature in nursing and management and a Content Validity Index (CVI) of .96 was computed on responses from a panel of five experts. In Phase 2, the scale was pilot-tested on a random sample of 106 psychiatric mental health nurses. In Phase 3, the revised scale was presented to a convenience sample of 112 nurses attending continuing education programs. Seven items were found to explain 40.6% of the variance in scores and were retained as the final unidimensional scale. Construct validity was supported by a difference in means of two groups that also differed on another measure of intuition.

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Section: Conceptual Backgroundmentioning

confidence: 99%

Acknowledging Intuition in Clinical Decision Making

Rew

2000

J Holist Nurs

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“…In an early study with a master's student, we examined the pulmonary artery catheter versus clinical evaluation for fluid management decisions after coronary artery bypass graft surgery. 2 We evaluated whether information provided by pulmonary artery catheters, which at the time were used almost universally in cardiac surgical patients, was used in fluid management decisions in stable patients beyond the initial 18 hours after surgery. We found that this information was never used and concluded that early removal of pulmonary artery catheters would not hinder the management of patients and may reduce the incidence of complications.…”

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confidence: 99%

As Health Care Technology Advances: Benefits and Risks

Funk

2011

American Journal of Critical Care

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Technology permeates every dimension of critical care. Bedside technology is integral to the assessment and monitoring of patients and to the provision of treatment. It also helps with access to vital information and can enhance commu nication. Although it offers extraordinary benefits to patients and clinicians, technology may also create problems. Our research addresses the wise use of technology in the care of critically ill patients. It examines the appropriate and safe use of technology, its equitable distribution, and the human-machine interface. Given that some devices are more effective and safe than others, it is important to assess the appropriateness of a specific technology in a specific situation. Just because a particular device is available, is it necessary to use it in every possible situation? Do we use it just because it is there? Do we employ "heroic" measures sometimes when it would be kinder not to? Studies on the safe use of technology in patient care lead to a consideration of the risk-benefit ratio. Our research on gender and racial differences in the use of cardiac procedures in patients with acute myocardial infarction focused on the equitable distribution of technology. The results of this line of research, along with those of numerous other studies, suggest possible racism in our health care practices. The human-machine interface, or how clinicians and patients interact with health care technology, is a crucial focus of research. Technology is at the heart of critical care. It allows clinicians to perform miracles, but is also a seductive and self-perpetuating force that needs careful monitoring by those who use it.

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