Nurses' cognitive and perceptual bias in the identification of clinical deterioration cues

Al‐Moteri, Modi; Cooper, Simon; Symmons, Mark; Plummer, Virginia

doi:10.1016/j.aucc.2019.08.006

Cited by 18 publications

(25 citation statements)

References 27 publications

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“…Besides those respondents, who do not want to be reminded of potential medication errors they have made, it is also possible that some respondents just cannot recall any mistakes made. Finally Al‐Moteri et al recently published studies, showing that the majority of nurses were often affected by cognitive and perceptual bias in the identification of clinical deterioration of patients, so there is no direct connection between a possible error and its consequences on care‐dependent individuals 31 …”

Section: Discussionmentioning

confidence: 99%

Patient safety in home care: A multicenter cross‐sectional study about medication errors and medication management of nurses

Strube‐Lahmann

Müller‐Werdan

Klingelhöfer‐Noe³

et al. 2022

Pharmacology Res & Perspec

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Studies assume that up to 30% of home care recipients are exposed to a possible medication error. For the home care sector, the study situation regarding such errors is limited. The aim of the study was to find out how often medication errors occur and whether they are related to training, quality assurance measures (use of the double‐check principle (DCP)), and other structural conditions of home care services. A cross‐sectional study was conducted, comprising 485 fully trained nurses of 107 randomly selected home care services. Potential influencing factors were analyzed in a multiple logistic regression model. Of 485 fully qualified nurses, 41.6% reported medication errors within a 12‐month period, while 14.8% did not answer this question. Nurses who had attended medication training within the last 2 years compared to a longer period (frequently to rather rarely applied DCP); the odds ratio of not making medication‐related errors was 1.79[1.42–3.09] (OR 3.13; [1.88–5.20]). Years of professional experience, amount of patients per shift, and type of work contract (full/part‐time) were not statistically significantly associated with reported medication errors. Medication‐related errors occur frequently in home care. Regular training and adequate quality management measures increase patient safety. Nursing managers and other responsible individuals of home care institutions have to make sure that nursing staff take part in regular medication training and apply the DCP when they give out medication in home care.

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Section: Discussionmentioning

confidence: 99%

Patient safety in home care: A multicenter cross‐sectional study about medication errors and medication management of nurses

Strube‐Lahmann

Müller‐Werdan

Klingelhöfer‐Noe³

et al. 2022

Pharmacology Res & Perspec

View full text Add to dashboard Cite

show abstract

“…A second round of a deductive analysis was initiated to enable an in-depth exploration of data in line with the existing literature. In the deductive analysis phase, the emerged codes were aligned with the findings of the previous studies presented in Al Moteri et al [ 4 ], Al Moteri et al 2020 [ 6 ], Al-Azri [ 17 ], Al Moteri [ 18 ]. In particular, the theoretical frameworks constructed by Al-Azri [ 17 ], Al Moteri [ 18 ] have guided the presentation of themes and codes and their interrelationships ( Table 1 ).…”

Section: Discussionmentioning

confidence: 99%

“…The problem may be explained in part by poor information processing, causing a delay in responding. Information processing refers to the ability to perceive, interpret and connect “relevant information whilst filtering out unnecessary information” to generate a decision and initiate actions [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In spite of the abundance of literature addressing the characteristics of emergency settings [ 4 , 8 , 9 , 10 ], there has not been a mental structure model proposed to understand the thought processes of clinicians and to identify particular cognitive weaknesses [ 6 ]. A better understanding may inform changes in both practice and decision-making in the emergency department setting.…”

Section: Introductionmentioning

confidence: 99%

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Mental model for information processing and decision-making in emergency care

Al‐Moteri

2022

PLoS ONE

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Background Uncertainty and time pressure in emergency departments add a challenge to the rational decision-making process, specifically when encountering a critical patient who requires a prompt response. However, there has been little attempt to develop a mental structure model to understand the thought processes and identify cognitive weaknesses points in nurses’ decision-making. A better understanding can inform changes in both practice learning strategies and decision-making in emergency department. This study aims to better understand how newly employed nurses process information and initiate actions in emergency situations characterized by time constraints and uncertainty. Method Participants worked under time pressure and uncertainty to solve a simulated shock case by establishing an assumption of what type of shock the simulated patient might have and its cause. An 8-minute window was available to initiate action. Following the simulation, a retrospective think-aloud interview was conducted. Findings Participants’ ability to identify the category of shock was better than their ability to identify the underlaying cause of the shock. This influenced their ability to intervene correctly. Participants’ thinking process in an emergency situation can be organized using ABCDE acronym as follows: (1) awareness of the situation, followed by, an instant (2) generation of beliefs (presumption), (3) controlling the consequence (first-line management action), (4) involvement in deliberate thinking and, finally (5) execution, actions (second-line management action). The cognitive weakness was mainly noticed during the first-line management action when participants were involved in immediate lifesaving activities. Conclusion Classification of the steps involved in decision-making when encountering emergency situations may provide insight into the strengths and weaknesses of the thought process at different stages. Further studies are required.

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“…The underlying decision-making process can be accurately recorded by eye-tracking technology. The technology has been applied in many fields, such as medicine and forensic science [15][16][17]. It provides a research paradigm and technical base for this study.…”

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confidence: 99%

The impact of contextual information on decision‐making in footwear examination: An eye‐tracking study

Luo

Huang

et al. 2021

Journal of Forensic Sciences

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In order to investigate whether context factors and expectations might potentially influence the decision-making of forensic footwear examiners, we collected the gaze process of experts examining the shoeprint image sets through the eye-tracking recorder. Additional to eye movement data as an objective measure, questionnaires were completed, and survey was conducted afterwards. Twenty-three qualified examiners assessed the similarity among shoe images for 22 different cases, including three sets were laterally reversed. We divided the experiment into two sessions, and then compared the examiners' performance with and without contextual information.The results showed the effects of contextual bias manipulate on both behavioral data and eye tracking data. The consensus and accuracy of examiners with contextual information were higher than those without contextual information. In the eye-tracking data, there is a significant difference between fixation counts and saccadic counts under contextual information. In addition, we found that the contextual information produced significant changes in inter-examiner consistency as measured by the Earth Mover Distance metric. However, there is no significant statistic differences in saccadic amplitude and total fixation duration of the examiners after exposure to contextual information. Our research results are instructive for understanding the cognitive process of shoeprint examination involved in real cases. In this process, stimuli related to context factors may affect decision-making and behavior. Implications for contextual effect causes are discussed.

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Nurses' cognitive and perceptual bias in the identification of clinical deterioration cues

Cited by 18 publications

References 27 publications

Patient safety in home care: A multicenter cross‐sectional study about medication errors and medication management of nurses

Patient safety in home care: A multicenter cross‐sectional study about medication errors and medication management of nurses

Mental model for information processing and decision-making in emergency care

The impact of contextual information on decision‐making in footwear examination: An eye‐tracking study

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