Could standing orders have a place? A phenomenological exploration of experienced ward‐based registered nurses' views on the escalation protocol for patient deterioration.
Aims and objectives: To explore experienced ward‐based Registered Nurses' views on the potential use of standing orders, prior to the escalation protocol, for patient deterioration. Background: Ward based nurses are required to follow set steps of the escalation protocol. The introduction of standin...
| Publicado en: | Journal of Clinical Nursing (John Wiley & Sons, Inc.) Vol. 31; no. 11/12; pp. 1669 - 1686 |
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| Autores principales: | , , |
| Formato: | questions and answers research tables/charts Journal Article |
| Publicado: |
John Wiley & Sons, Inc.
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=156901579&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 156901579 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09621067 LVDZ jtl: Journal of Clinical Nursing (John Wiley & Sons, Inc.) issn: 09621067 maglogo: N pubinfo: dt: Jun2022 vid: 31 iid: 11/12 pid: 52269 pub: John Wiley & Sons, Inc. artinfo: ui: 156901579 152173811 156901579 156901579 10.1111/jocn.16022 156901579 ppf: 1669 ppct: 17 formats: tig: atl: Could standing orders have a place? A phenomenological exploration of experienced ward‐based registered nurses' views on the escalation protocol for patient deterioration. aug: au: Minyaev, Stanislav Harrington, Ann King, Lindy affil: College of Nursing and Health Sciences, Flinders University, Adelaide SA,, Australia sug: subj: Clinical Deterioration Registered Nurses Psychosocial Factors Nurse Attitudes Medical Practice, Evidence-Based Nursing Protocols Human Phenomenology Semi-Structured Interview Conceptual Framework Purposive Sample Outcomes (Health Care) Nursing Interventions ab: Aims and objectives: To explore experienced ward‐based Registered Nurses' views on the potential use of standing orders, prior to the escalation protocol, for patient deterioration. Background: Ward based nurses are required to follow set steps of the escalation protocol. The introduction of standing order policies would allow nurses to intervene earlier when deterioration was first detected. Design: Hermeneutic Phenomenology. Methods: Ten experienced ward‐based RNs were recruited. Semi‐structured interviews were conducted, with the data subjected to thematic analysis. Diekelmann's framework was used to analyse the texts, seeking the highest level of hermeneutic analysis namely, a constitutive pattern. COREQ guidelines were utilised. Results: Four main themes emerged: (1) Ambiguity in perception: the escalation protocol; (2) Observations within acceptable parameters, but the patient is deteriorating; (3) Paradoxes of escalation: well laid out protocol, but hard to escalate; (4) We could intervene with standing orders, but are we permitted? The constitutive pattern namely, Dualism in Perception related to the dissonance conveyed by participants regarding the escalation protocol. Conclusions: Notwithstanding the benefits of the escalation protocol for junior staff, the RNs offered critique of the established escalation practices and the restrictive role of the protocol. Another aspect of the protocol, that is 'worried criterion' was viewed positively. The participants expressed a desire to apply nurse‐driven standing orders, to enable them to intervene earlier for patient deterioration. Relevance to clinical practice: Organisations should consider new policies introducing standing orders for implementation by experienced RNs. The engagement of experienced ward‐based nurses in forming 'patient at‐risk teams' could assist organisations to deal with cases of clinical deterioration prior to activation of the escalation of care protocol. pubtype: Academic Journal doctype: questions and answers research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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