The creation of a simulated rural hospital nursing unit for the purpose of conducting research

Sedgwick, Monique; Dersch, Sharon; Grigg, Lance

doi:10.5430/jnep.v4n9p27

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Specifically, the participants worked through a 30-minute scenario where they interacted with high-and medium-fidelity mannequins as well as real-life actors. Using the simulated environment is discussed in detail elsewhere 27 . At the completion of the scenario, the participants were interviewed by one of the researchers.…”

Section: Data Generationmentioning

confidence: 99%

Deepening the quality of clinical reasoning and decision-making in rural hospital nursing practice

Sedgwick

Grigg

Dersch

2014

RRH

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Introduction: Rural acute care nursing requires an extensive breadth and depth of knowledge as well as the ability to quickly reason through problems in order to make sound clinical decisions. This reasoning often occurs within an environment that has minimal medical or ancillary support. Registered nurses (RN) new to rural nursing, and employers, have raised concerns about patient safety while new nurses make the transition into rural practice. In addition, feeling unprepared for the rigors of rural hospital nursing practice is a central issue influencing RN recruitment and retention. Understanding how rural RNs reason is a key element for identifying professional development needs and may support recruitment and retention of skilled rural nurses. The purpose of this study was to explore how rural RNs reason through clinical problems as well as to assess the quality of such reasoning. Methods: This study used a non-traditional approach for data collection. Fifteen rural acute care nurses with varying years of experience working in southern Alberta, Canada, were observed while they provided care to patients of varying acuity within a simulated rural setting. Following the simulation, semi-structured interviews were conducted using a substantive approach to critical thinking. Results: Findings revealed that the ability to engage in deep clinical reasoning varied considerably among participants despite being given the same information under the same circumstances. Furthermore, the number of years of experience did not seem to be directly linked to the ability to engage in sound clinical reasoning. Novice nurses, however, did rely heavily on others in their decision making in order to ensure they were making the right decision. Hence, their relationships with other staff members influenced their ability to engage in clinical reasoning and decision making. In situations where the patient's condition was deteriorating quickly, regardless of years of experience, all of the participants depended on their colleagues when making decisions and reasoning throughout the simulation. Conclusions: Deep clinical reasoning and decision making is a function of reflection and self-correction that requires a critical selfawareness and is more about how nurses think than what they think. The degree of sophistication in reasoning of experts and novices © MG Sedgwick, L Grigg, S Dersch, 2014. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2 is at times equivalent in that the reasoning of experts and novices can be somewhat limited and focused primarily on human physicality and less on conceptual knowledge. To become proficient in clinical reasoning, practice is necessary. The study supports the accumulating evidence that using clinical simulation and reflective interviewing that emphasize how clinical decisions are made enhances reasoning skills and confidence.

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Section: Data Generationmentioning

confidence: 99%

Deepening the quality of clinical reasoning and decision-making in rural hospital nursing practice

Sedgwick

Grigg

Dersch

2014

RRH

Self Cite

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Institutionalizing Clinical Reasoning: A Grounded Theory of the Clinical Reasoning Processes RNs Use to Recognize Delirium

Hussein¹,

Hirst²

2015

J Gerontol Nurs

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Delirium is a common disorder among hospitalized older adults often leading to prolonged hospitalization, increased health care costs, and sometimes death. The goal of the current study was to construct a grounded theory that explains the clinical reasoning processes that RNs use to recognize delirium in older adults in acute care settings. Seventeen participants in three hospitals were interviewed. The core category that emerged from the data was institutionalizing clinical reasoning. Findings from the current study can be a starting point for RNs to bring self-awareness to variables that influence their reasoning processes.

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The creation of a simulated rural hospital nursing unit for the purpose of conducting research

Cited by 2 publications

References 14 publications

Deepening the quality of clinical reasoning and decision-making in rural hospital nursing practice

Deepening the quality of clinical reasoning and decision-making in rural hospital nursing practice

Institutionalizing Clinical Reasoning: A Grounded Theory of the Clinical Reasoning Processes RNs Use to Recognize Delirium

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