The purposes of this study were to describe the decision making process and decision activities of critical care nurses in natural clinical settings. An exploratory descriptive approach utilizing both interview and observation methods, was used for data collection. The study involved twenty four critical care nurses from three hospitals in Jordan. Participant observation was performed to understand the routine clinical decisions made by Intensive Care nurses. About 150 hours of observations were spent in the involved Intensive Care Units. Nurses were interviewed to elicit information about how they made decisions about patient's care. The study revealed that the most common model nurses tend to use was intuitive model in order to observe the cues relating to the patient's situation. Data revealed that the decision making process is continuous and that experience is one of the main factors that determine nurses' ability to take decisions. Five themes were generated from the data: on-going process, autonomy, experience/power, joint/ethical decisions, and advocacy. Critical care nurses were seen to be sensitive to the patient's verbal and non-verbal cues; they were able to respond to these evidences to ensure that the patient's condition did not deteriorate. Critical care nurses are likely to be more confident and effective when dealing with patient's changing situations with more experience.
Background: Nursing students are at risk for committing medication administration errors (MAEs), which significantly alter the delivery of safe and effective healthcare. Purpose: To identify the medications most frequently involved in medication errors as reported by Jordanian nursing students, as well as to identify the level of nursing students' adherence to best-practice when administering high-risk medications. Methods: A cross-sectional design was used among a convenience sample of 74 nurses. Results: A total of 74 of 110 (67.3%) questionnaires were returned. The most frequent medications subjected to MAEs were Dopamine, Dobutamine, and Insulin continuous intravenous infusion (17.2%, 16.0% and 13.5% respectively). Regarding the adherence to best-practice, nursing students adhered the most to the following best-practices: checking the patient armband prior to medication administration with a mean of 3.81 (±0.6) and bringing the MAR sheet with them when preparing a medication with a mean of 3.46 (±1.1). Conclusion: Developing an effective medication training programs in all undergraduate nursing programs in Jordanis is vital to ensure patient safety. Nursing educators in clinical and academic settings need to reinforce the importance of adherence to medication management best-practice in all courses. Close and effective supervision of students needs to be maintained throughout nursing students' clinical training, especially during medication preparation and administration.
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