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The article presents a research study published to present the critical-thinking process in practicing medical-surgical registered nurses (RNs) through self-reporting. Topics covered include the highlights of previous research articles relating to critical thinking, critical reasoning, and nurse thought, details relating to the Critical Thinking Diagnostic tool used in the study, and the need for all nurses to develop critical-thinking skills for job satisfaction and improved patient outcomes.

The article presents a study on peripheral intravenous site care using Duffy's Quality-Caring Model. It discusses findings on the complication rates of phlebitis and infiltration between site rotation of peripheral intravenous catheters based on clinical assessment by nurses in a medical-surgical unit and length of time and implications for medical-surgical nursing practice and existing policies for venous access.

Introduction The results are presented from a grounded theory study that theorized nurse physician collaboration as a basic social process in which groups are formed and changed in harmony. Effective collaboration is essential to superior patient care and outcomes but a lack of theoretical basis for collaboration has hampered the study of collaboration and the optimization of patient care. Purpose The purpose of this study was to theorize collaboration as a basic social process occurring between nurses and physicians. Method Grounded theory was used to explore nurses' and physicians' experiences with collaboration to understand the process intrinsically. Following Institutional Review Board approval, 15 nurses and 7 resident physicians from various units within an academic medical center participated in face-to-face interviews regarding their experiences of collaboration. Data collection and constant comparison analysis continued concurrently until saturation was reached in the core and subsequent categories. Findings The basic social process of nurse-physician collaboration that emerged includes the core category of working together toward a common goal. It describes how nurses and physicians collaborate for patient care. The seven stages in the process are something needs our attention, knowing who to talk to, finding the right person, coming together, exchanging ideas and information, making it happen, and monitoring progress. Conclusion Working together toward a common goal is an empirically derived theory that can guide education and practice to improve patient outcomes, while saving money and lives. [ABSTRACT FROM AUTHOR]

The article discusses the implementation of Clinical Decision Units (CDUs) for patients with congestive heart failure in the U.S. Topics covered include the impact of CDU on clinical care, its financial benefits, and the opportunities it provide for the nurse leaders. The advantages and limitations of CDU are also mentioned.

The article discusses about oral anticoagulants and its significance in preventing stoke associated with atrial fibrillation (AF). Among the key notable anticoagulants in the market include aspirin, warfarin, and dabigatran. Information regarding patient education, laboratory monitoring, and nursing assessment, are also discussed.

Background: The purpose of rapid response teams (RRTs) is to reduce cardiopulmonary arrest and hospital mortality rates, and prevent failure to rescue (FTR). Silber, Williams, Krakauer, and Schwartz (1992) coined the term failure to rescue to describe the death of patients who suffered a post-surgical complication that was not addressed promptly. Between 2008 and 2010, 21,773 postoperative Medicare patients died in U.S. hospitals from FTR. The literature indicates RRTs are underutilized and underutilization of RRTs can lead to FTR. This comes in the form of delayed RRT activation or complete failure to activate the RRT when the patient's condition warrants. It indicates failures in the recognition of and reaction to sudden clinical deterioration, both of which require registered nurses (RNs) to utilize their critical thinking and decision-making skills. Increased frequency of RRT activation has been correlated to reduced patient mortality. Objective: The objective of this study was to determine the relationships between nurses' decision-making model during RRT activation and the frequency of RRT activation. Method: Participants in this study were 87 acute care RNs working in medical-surgical units who had activated the RRT at least once in the preceding 12 months. They completed a demographic questionnaire and self-reported the number of calls to the RRT in the preceding 12 months. The participants were asked to recall a time they had activated the RRT for a patient and then completed the Nurse Decision-Making Instrument (NDMI). The NDMI classified participant's decision-making process during RRT activation into one of three categories: analytic, analytic/intuitive (mixed model), or intuitive decision making. Results: Of the 87 RNs in this study, 70.1% (n=61) used an analytic/intuitive decision-making model, 21.8% (n=19) used an analytic decision-making model, and 8% (n=7) used an intuitive decision-making model during RRT activation. The frequency of RRT calls ranged from 1 to 15 (M=3.0, SD=2.6). Analytic decision makers had a mean of 4.7 RRT calls, analytic/intuitive decision makers had a mean of 2.56 RRT calls, and intuitive decision makers had a mean of 2.3 RRT calls. A one-way ANOVA indicated the differences in number of RRT calls between the three decision-making models was significant (p=0.003). The findings of this study indicated RNs who used analytical decision making activated the RRT with significantly greater frequency than either intuitive or mixed model decision makers. Discussion: The relationship between nurse decision-making models and patient outcomes needs to be investigated further. Because increased frequency of RRT activation has been associated with analytic decision making in this study and linked to decreased patient mortality rates in the literature, the potential to impact patient's outcomes positively, reduce hospital mortality rates, and reduce FTR exists. Nurses should be trained in analytical decision make and ongoing efforts should be made to support and enhance nurses' use of RRTs. [ABSTRACT FROM AUTHOR]