Search

Background: The clinical observations made by critical care nurses are vital for maintaining patient safety and making appropriate decisions in the care of patients who are critically ill. Evaluating the reliability of observations and applying analytical thinking are essential elements of patient observation. Previous studies of critical care nurses' knowledge have focused either on specific aspects of patient observation or on critical care nursing in general; therefore, the findings are not comprehensive., Aim: The aim of this study was to evaluate critical care nurses' level of knowledge in patient observation and to explore the factors that are associated with it., Study Design: A cross-sectional knowledge test survey with critical care nurses in Finland was used., Methods: Data were collected in seven adult intensive care units in all five university hospitals in Finland between September 2017 and January 2018 by using a knowledge test (20 items) developed for this study. All critical care nurses were eligible to participate. The data were analysed using descriptive and inferential statistics., Results: Altogether, 372 nurses responded (response rate 49%). Their average scores in the knowledge test were 77% (mean 15.29/20, SD 2.41) for correct answers, 75% (mean 8.2/11, SD 1.54) in the sum-variable "Evaluating the reliability of observation" and 79% (mean 7.08, SD 1.45) for "Analytical thinking." A higher knowledge level was associated with education in special tasks in an intensive care unit., Conclusion: The critical care nurses' knowledge level was considered to be suboptimal. There is a need for improving knowledge of patient observation among Finnish critical care nurses to ensure safe and good quality care., Relevance to Clinical Practice: Finnish critical care nurses' knowledge of patient observation could be improved by providing specific continuing education for new nurses entering intensive care units and for experienced critical care nurses throughout their career., (© 2020 British Association of Critical Care Nurses.)

Background: We examined the patterns of hand hygiene compliance (HHC) among health care providers (HCP) as observed by trained nurse and patient auditors over time in an ambulatory care Canadian provincial cancer agency., Methods: Nurse and volunteer patient auditors completed separate standardized forms documenting hand-cleansing opportunities during clinic visits. HHC rates were compared over time by HCP group and by specialty teams. Observations from 10 calendar quarters were analyzed from April 2015 to September 2019., Results: Nurse audit HHC rates ranged from 84% to 96%, encompassing 7,213 opportunities with no significant time-dependent trends by linear regression (R 2  = 2.3E-005, P = .9895). The patient audit HHC rates ranged from 57% to 82%, encompassing 23,402 opportunities, were lower overall compared to the nurse audit (73.6% vs 89.2%, respectively, P < .0001), but displayed an increasing trend (R 2  = 0.5374, P = .0159) over the same 10 time periods. The relative risk ratio for the differences decreased over time (R 2  = .5101, P = .0203). Patients acknowledged the importance of HHC and the audit process, but were reticent to remind HCP to comply., Conclusions: The nurse audit measuring HCP HHC before entering and after exiting patient examination rooms showed persistently high compliance over time whereas the patient-driven audit measuring HHC within the examination room increased over time suggesting a training effect upon practice. These measures appeared complementary., (Copyright © 2020. Published by Elsevier Inc.)

Background: Observing a patient's clinical condition is an important responsibility of critical care nurses and an essential component of their competence. Critical care nurses' patient observation skills contribute to patient safety and quality of care. These observation skills have not been assessed or measured previously., Aim: The aim of this study was to measure the self-assessed level of critical care nurses' patient observation skills and to explore the factors associated with these skills., Study Design: This was a multicentre cross-sectional survey conducted in Finland., Methods: The sample consisted of critical care nurses working at Finnish university hospitals. The data were collected between September 2017 and January 2018 using an instrument developed for the study - Patient Observation Skills in Critical Care Nursing (visual analogue scale 0-100). Descriptive and inferential statistics were used to analyse the data., Results: A total of 372 critical care nurses (49%) responded. Finnish critical care nurses assessed their patient observation skills overall as excellent. The bio-physiological foundation was assessed as good, whereas skills in using observation methods and skills in recognizing changing clinical condition were assessed as excellent. Education for special tasks in intensive care units, information searching in scientific journals, working experience in critical care nursing and critical care nurses' perception of critical care as a preferred field of nursing were factors promoting patient observation skills., Conclusions and Relevance to Clinical Practice: The study provided a novel instrument for measuring critical care nurses' patient observation skills. The instrument may be used as an assessment tool in clinical practice and education. Developing orientation and on-the-job training in intensive care units are essential in assuring critical care nurses' adequate patient observation skills. Patient observation skills could be developed during nursing education by providing students with opportunities for clinical training and applying patient cases in virtual learning environments., (© 2019 British Association of Critical Care Nurses.)

Objectives: The aim of this study was to provide a comprehensive description of multiple skills in patient observation in critical care nursing., Research Methodology: Data from semi-structured interviews were analysed using thematic analysis., Setting: Experienced critical care nurses (n=20) from three intensive care units in two university hospitals in Finland., Findings: Patient observation skills consist of: information gaining skills, information processing skills, decision-making skills and co-operation skills. The first three skills are integrated in the patient observation process, in which gaining information is a prerequisite for processing information that precedes making decisions. Co-operation has a special role as it occurs throughout the process., Conclusion: This study provided a comprehensive description of patient observation skills related to the three-phased patient observation process. The findings contribute to clarifying this part of the competence. The description of patient observation skills may be applied in both clinical practice and education as it may serve as a framework for orientation, ensuring clinical skills and designing learning environments. Based on this study, patient observation skills can be recommended to be included in critical care nursing education, orientation and as a part of critical care nurses' competence evaluation., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Implementing harm reduction is among the administrative tasks used for maintaining a safe unit for psychiatric in-patients. Such harm may be potentially caused by patients themselves or others. Included in nursing procedures implemented for observing suicidal patients is the practice of 15-minute checks. In reviewing the standard forms used for such procedures in several major hospitals across the United States, we noticed a wide variation in the format and use of 15-minute checks, as well as poor guidelines for their termination. We recommend that the observation practice of 15-minute checks be eliminated from the repertoire of nursing protocols for suicidal patients who are assessed to be at imminent risk for self harm on inpatient units.