Potential uses of AI for perioperative nursing handoffs: a qualitative study.

Objective: Situational awareness and anticipatory guidance for nurses receiving a patient after surgery are key to patient safety. Little work has defined the role of artificial intelligence (AI) to support these functions during nursing handoff communication or patient assessment. We used interviews and direct observations to better understand how AI could work in this context. Materials and Methods: 58 handoffs were observed of patients entering and leaving the post-anesthesia care unit at a single center. 11 nurses participated in semi-structured interviews. Mixed inductive-deductive thematic analysis extracted major themes and subthemes around roles for AI supporting postoperative nursing. Results: Four themes emerged from the interviews: (1) Nurse understanding of patient condition guides care decisions, (2) Handoffs are important to nurse situational awareness; problem focus and information transfer may be improved by AI, (3) AI may augment nurse care decision making and team communication, (4) User experience and information overload are likely barriers to using AI. Key subthemes included that AI-identified problems would be discussed at handoff and team communications, that AI-estimated elevated risks would trigger patient re-evaluation, and that AI-identified important data may be a valuable addition to nursing assessment. Discussion and Conclusion: Most research on postoperative handoff communication relies on structured checklists. Our results suggest that properly designed AI tools might facilitate postoperative handoff communication for nurses by identifying elevated risks faced by a specific patient, triggering discussion on those topics.

Unsatisfactory completeness of nurses’ records in the medical records of users with tuberculosis

ABSTRACT Objectives: to evaluate the completeness of nurses’ records on the execution of the nursing process in assistance of tuberculosis patients at Primary Care. Methods: this was a retrospective documental study, with 190 records in Family Health Units of a city in the state of Paraíba. The data were analyzed according to descriptive statistics, Pareto Diagram, and trend analysis. Results: the overall mean incompleteness of records was 53.01% (DP=26.13). Therefore, the results presented very poor completeness classification related to nursing diagnosis (88.9%), nursing assessment (66.8%), data collection (60.5%), while nursing interventions were classified as regular (11.1%). The nursing diagnosis was the only variable with a decreasing trend of non-completeness. Conclusions: incompleteness of nurses’ records in the medical records of users with tuberculosis. Evaluation strategies, permanent and continuing education are indispensable in the quality of nurses’ documentation, directly implying the Systematization of Quality in Nursing Care.

Knowledge of ICU Nurses Regarding the Ongoing Nursing Assessment of ICU Patients in Khartoum City, 2020

Background: An ongoing nursing assessment is the most significant point in the nursing process to be executed in the beginning of every shift which can be accomplished by using different approaches. It needs to be conducted accurately to guide professional nurses’ decision-making ability to further provide holistic nursing care to patients in the intensive care units (ICUs). This study was aimed to assess the ICU nurses’ knowledge regarding ongoing nursing assessment of ICU patients. Methods: This descriptive cross-sectional hospital-based study was conducted in Khartoum city, and included 86 out of the 135 participants working in the critical care units of the main governmental hospitals in Khartoum city. Data were collected using a structured self-administered questionnaire after being tested for validity and then analyzed using mean, standard deviation, and correlation. Data were then presented as frequencies and percentages. Results: The study participants were aged between 20 and 40 years with a female to male ratio of 3:1, and varied levels of experience. Overall, 71.7% of the studied participants scored good on the standardized knowledge classification tool used, with few areas of knowledge gap, impacted by increased experience. Moreover, 36% of the participants used the ABCDE approach for ongoing nursing assessment, followed by the head-to-toe assessment approach (21%). Conclusion: The nurses’ knowledge regarding ongoing nursing assessment was good with a few areas of weakness raising the need for continuous educational and training programs.

Development and Implementation of Pediatric Nursing-Clinical Decision Support System for Hyperthermia: A Pre- and Post-Test

Firstly, we form the Pediatric Nursing-Knowledge Base for Hyperthermia, which combines publicly clinical practice guidelines and nursing routines of hyperthermia management. Then, following the nursing process framework, the system is developed by clinical decision support technology. Finally, a pre- and post-test is adopted to examine the effectiveness, usability and feasibility before and after using the system. Its effectiveness is examined by nursing records quality including completeness of nursing assessment, timeliness of nursing diagnosis, individualization of nursing interventions, and timeliness of nursing evaluation. Its usability and feasibility are assessed using the Clinical Nursing Information System Effectiveness Evaluation Scale. There is a significant difference between the two groups in effectiveness, usability and feasibility. Although the system is developed specifically for our hospital workflow and processes, the Pediatric Nursing-Knowledge Base for Hyperthermia and workflow for hyperthermia management in this study can be used as a reference to other hospitals.

Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

<p>Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes.</p>

Determining Competency for Entry to Nursing Practice: A Grounded Theory Study

<p>Critical Comparative Nursing Assessment (CCNA) is a theory about how the competence of completing Bachelor of Nursing students in New Zealand is determined. Semi-structured, audio-taped interviews and field notes were used to collect data from twenty-seven nurses with experience in undertaking competency assessment. A Glaserian grounded theory approach was used to guide the data collection and analysis. This utilised the processes of constant comparative analysis, theoretical sampling and saturation to generate a middle range substantive grounded theory. This is presented as a model consisting of four emergent categories that explain how nurses formulate professional judgements about competence. These are a) gathering, which describes the processes used to collect evidence of practice to inform decisions; b) weighing up, which explains how evidence is analysed using the processes of benchmarking and comparative analysis; c) judging brings into focus the tensions inherent in making professional judgements about competence and how nurses formulated these, and d) moderating, which describes the processes nurses use to validate decisions and ensure that professional responsibilities and public safety are upheld. The basic social psychological process of comparing integrates these categories to explain how nurses resolve the tensions associated with making decisions about competence. This research presents a new way of viewing and understanding how nurses assess competence. It identifies where the challengers and tensions related to the assessment of competence lie and suggests strategies that if implemented could further enhance the validity and reliability of assessment outcomes.</p>

Improving Detection of Client Complexity in the Community (Impact): A Study Protocol of a Pragmatic Randomized Controlled Trial

Background: Community-dwelling older clients are becoming increasingly complex. Detecting this complexity in clinical practice is limited, with greater reliance on community nurses’ clinical judgment and skills. The lack of a consistent approach to complexity impacts the level of care and support for older clients to remain in their homes for longer. Objective: To examine the effectiveness of the Patient Complexity Instrument (PCI) in addition to nurses’ clinical judgment to enhance detection of complexity, and subsequent older clients’ resource allocation compared to usual nursing assessment. Design: A pragmatic randomized controlled trial will be conducted within a community nursing service in regional Victoria, Australia. Clients 65 years and over referred to the service who are eligible for Commonwealth Home Support Programme (CHSP) funding will be randomized into Control group: usual nursing assessment or Intervention group: usual nursing assessment plus the PCI. Nurse participants are Registered Nurses currently employed in the community nursing service. Results: This study will explore whether introducing the PCI in a community nursing service enhances detection of complexity and client care resource allocation compared to nurses’ clinical judgment based on usual nursing assessment. Conclusion: This protocol outlines the study to enhance the detection of complexity by nurses delivering care for community-dwelling older people in the regional Australian context. The findings will inform the use of a standardized tool to detect complexity among community-dwelling older Australians.