The emergent relevance of care staff decision‐making and situation awareness to mobility care in nursing homes: an ethnographic study

Abstract

Care staff may benefit from support via collaborative and reflective practice to develop decision-making skills, situation awareness and person-centred mobility care. Further research is required to explore the connection between staff's skills in mobility care and their decision-making competence as well as how these factors link to quality mobility care.

Patients' and nurses' experiences of fundamental nursing care: A systematic review and qualitative synthesis

“…Of the 16 high‐quality studies, study designs were reported as grounded theory (3), ethnography (2), phenomenology (1), soft systems approach (1) and interpretative description (1), or reported as content analysis (3), thematic analysis (2), or framework analysis (1) or did not name the methodological orientation (2). Papers reported qualitative data for observational studies ( n = 12) (Boltz et al, ; Bourret, Bernick, Cott, & Kontos, ; Coyer, O'Sullivan, & Cadman, ; Gaspard & Cox, ; Kitson, et al, 2013b; Kneafsey, Clifford, & Greenfield, ; Lafreniére, Folch, & Bèdard, ; Lomborg et al, ; Sjögren Forss, Nilsson, & Borglin, ; Taylor, Sims, & Haines, , ; Wardh, Hallberg, Berggren, Andersson, & Sorensen, ) and experimental studies ( n = 4) where new practices were introduced (French et al, ; Jensen et al, ; Robison et al, ; Thomas et al, ). Of these, two papers included patient data about a new nursing care method.…”

“…Patients reported valuing mobility and independence (Boltz et al, ; Bourret et al, ; Kitson et al, 2013b; Lafreniére et al, ; Taylor, Sims, & Haines, ; Taylor et al, ) and being assisted and encouraged to move according to abilities (Lafreniére et al, ). Patients appreciated actions to prevent falls (Lafreniére et al, ).…”

“…Nurses noticed patients associating self‐worth with mobility (Bourret et al, ). Nurses considered effective strategies to promote independent mobility that involved providing encouragement, setting specific and achievable goals with patients, using appropriate mobility aids, pain relief prior to activities, developing flexible care plans with patients and adjusting these as patients or residents mobility improved (Boltz et al, ; Bourret et al, ; Kitson, Conroy, et al, ; Lafreniére et al, ; Taylor et al, ). Other studies showed nurses paid limited attention to patients' rehabilitation goals but instead were concerned with “care to keep safe” (Kneafsey et al, ) and prevention of potential problems including falls (Kneafsey et al, ; Lafreniére et al, ; Taylor et al, ).…”

“…Nurses reported feeling able to incorporate nursing care initiatives into their practice when time had been dedicated to training and support to learn (French et al, ; Robison et al, ; Thomas et al, ). Competence was evident when training was well supported and structured, but learning was also led by peer leaders who offered informal feedback and training, supervision and support to less competent or less experienced nurses (Taylor et al, ; Thomas et al, ; Wardh et al, ).…”

An exploratory mixed methods study of urban and rural registered nurses’ experience of clinical reasoning

“…Initial search terms included: clinical reasoning, decision-making, practice setting, context, and work setting. Studies that investigate nurses' clinical reasoning fall into the following general categories: 1) ethical decision making; [12,13] 2) clinical reasoning for specific nursing procedures; [14,15] 3) decision-making and specific illnesses; [16,17] 4) decision-making within specific practice settings; [18,19] and 5) decision-making in nursing using simulation. [20,21] Contextual factors that influence clinical decision making that have been studied include: education, [5,22,23] experience, [3,24] level of appointment, [18] age, [25,26] and occupational orientation.…”