Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Ebert, Lyn; Massey, Debbie; Flenady, Tracy; Nolan, Samantha; Dwyer, Trudy; Reid‐Searl, Kerry; Ferguson, Bridget; Jefford, Elaine

doi:10.1111/birt.12665

Cited by 3 publications

(1 citation statement)

References 47 publications

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“…At noon, Ms P's temperature remains low (34.3° C [93.7° F]) and she reports feeling cold 10 minutes later. The anesthesiologist amends the discharge criteria (ie, the Maternal Early Warning Tool [MEWT]) 20 for Ms P before her discharge from the PACU. At 12:20 PM, her temperature is 34.8° C (94.6° F).…”

Section: Resultsmentioning

confidence: 99%

Hypothermia With Paradoxical Symptoms: A Case Series of Cesarean Deliveries With Intrathecal Morphine

Munday¹,

Ramis²,

Kynoch³

et al. 2023

AORN Journal

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Women receiving intrathecal morphine for cesarean delivery may experience hypothermia with paradoxical symptoms of sweating, nausea, and shivering. Despite being relatively rare in comparison to commonly experienced symptoms of perioperative hypothermia, hypothermia with paradoxical symptoms affects early maternal recovery and comfort. The cause is undetermined, and treatment approaches vary. Regular active‐warming strategies may not be tolerated because of the paradoxical symptoms of sweating and feeling overheated. This case series aims to explore the phenomenon through the evaluation of health care records of women receiving intrathecal morphine for cesarean delivery at a single, tertiary health care institution in Australia from 2015 to 2018. We also summarize published literature to review treatment approaches used in the care of women experiencing profound heat loss while feeling overheated.

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Section: Resultsmentioning

confidence: 99%

Hypothermia With Paradoxical Symptoms: A Case Series of Cesarean Deliveries With Intrathecal Morphine

Munday¹,

Ramis²,

Kynoch³

et al. 2023

AORN Journal

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Nurse by numbers: The impact of early warning systems on nurses' higher‐order thinking, a quantitative study

Le Lagadec,

Massey,

Byrne

et al. 2024

Journal of Advanced Nursing

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AimTo evaluate registered nurses' perceptions of whether the mandated use of the early warning system vital signs tool impacts the development of nurses' higher‐order thinking skills.DesignA concurrent mixed methods study design.MethodUsing an online survey, registered nurses' perceptions were elucidated on whether early warning system algorithmic tools affected the development of their higher‐order thinking. Likert‐type matrix questions with additional qualitative fields were used to obtain information on nurse's perceptions of the tool's usefulness, clinical confidence in using the tool, compliance with escalation protocols, work environment and perceived compliance barriers.ResultsMost of the 305 (91%) participants included in the analysis had more than 5 years of nursing experience. Most nurses supported the early warning tool and were happy to comply with escalation protocols if the early warning score concurred with their assessment of the patient (63.6%). When the score and the nurse's higher‐order thinking did not align, some had the confidence to override the escalation protocol (40.0%), while others omitted (69.4%) or inaccurately documented vital signs (63.3%) to achieve the desired score. Very few nurses (3.6%) believe using early warning tools did not impede the development of higher‐order thinking.ConclusionAlthough experienced nurses appreciate the support of early warning tools, most value patient safety above the tools and rely on their higher‐order thinking. The sustained development and use of nurses' higher‐order thinking should be encouraged, possibly by adding a critical thinking criterion to existing algorithmic tools.ImpactThe study has implications for all nurses who utilize algorithmic tools, such as early warning systems, in their practice. Relying heavily on algorithmic tools risks impeding the development of higher‐order thinking. Most experienced nurses prioritize their higher‐order thinking in decision‐making but believe early warning tools can impede higher‐order thinking.Patient or Public ContributionRegistered nurses participated as survey respondents.

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Early warning tools and clinician ‘agency’ for strengthening safety culture: An integrative review

Ferguson,

Baldwin,

Henderson

2024

Journal of Advanced Nursing

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AimIdentify and analyse literature investigating nurses' and midwives' use of early warning tools during the care of adult inpatients.DesignAn integrative literature review.MethodsWhittemore and Knafl's (2005) framework guided this integrative review. PubMed, CINAHL, EMCARE and Google Scholar were systematically searched. The authors assessed the methodological quality of 21 papers meeting inclusion criteria and thematically analysed key data.ResultsThree main themes were identified, each with further sub‐themes.ConclusionEarly warning tools operate within various systems and cultural contexts. However, their potential for improved patient safety may be hindered. Protocols influencing tool usage may make nurses and midwives distanced from patients and their expertise. For early warning tools to enhance patient safety, assessing their integration into practice is crucial to maximizing effectiveness.ImpactThis review emphasizes the importance of integrating human relationships with early warning tools for patient safety.Patient or Public ContributionThis integrative literature review does not include patient or public input.Implications for Practice/PolicyAdapting early warning tools to balance standardization for safety and efficiency and promoting nurses' and midwives' expertise and autonomy is required to optimize delivery of quality care and uphold patient safety.Reporting MethodThe Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidelines were used.

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Midwives’ recognition and response to maternal deterioration: A national cross‐sectional study

Cited by 3 publications

References 47 publications

Hypothermia With Paradoxical Symptoms: A Case Series of Cesarean Deliveries With Intrathecal Morphine

Hypothermia With Paradoxical Symptoms: A Case Series of Cesarean Deliveries With Intrathecal Morphine

Nurse by numbers: The impact of early warning systems on nurses' higher‐order thinking, a quantitative study

Early warning tools and clinician ‘agency’ for strengthening safety culture: An integrative review

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