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Identifying factors that nurses consider in the decision-making process related to patient care during the COVID-19 pandemic.
Anton, Nicholas; Hornbeck, Tera; Modlin, Susan; Haque, Md Munirul; Crites, Megan; Yu, Denny.
  • Anton N; School of Industrial Engineering, Purdue University, West Lafayette, IN, United States of America.
  • Hornbeck T; School of Nursing, Purdue University, West Lafayette, IN, United States of America.
  • Modlin S; School of Nursing, Purdue University, West Lafayette, IN, United States of America.
  • Haque MM; RB Annis School of Engineering, University of Indianapolis, Indianapolis, IN, United States of America.
  • Crites M; School of Industrial Engineering, Purdue University, West Lafayette, IN, United States of America.
  • Yu D; School of Industrial Engineering, Purdue University, West Lafayette, IN, United States of America.
PLoS One ; 16(7): e0254077, 2021.
Article in English | MEDLINE | ID: covidwho-1295523
ABSTRACT

BACKGROUND:

Nurse identification of patient deterioration is critical, particularly during the COVID-19 pandemic, as patients can deteriorate quickly. While the literature has shown that nurses rely on intuition to make decisions, there is limited information on what sources of data experienced nurses utilize to inform their intuition. The objectives of this study were to identify sources of data that inform nurse decision-making related to recognition of deteriorating patients, and explore how COVID-19 has impacted nurse decision-making.

METHODS:

In this qualitative study, experienced nurses voluntarily participated in focused interviews. During focused interviews, expert nurses were asked to share descriptions of memorable patient encounters, and questions were posed to facilitate reflections on thoughts and actions that hindered or helped their decision-making. They were also asked to consider the impact of COVID-19 on nursing and decision-making. Interviews were transcribed verbatim, study team members reviewed transcripts and coded responses, and organized key findings into themes.

RESULTS:

Several themes related to decision-making were identified by the research team, including identifying patient care needs, workload management, and reflecting on missed care opportunities to inform learning. Participants (n = 10) also indicated that COVID-19 presented a number of unique barriers to nurse decision-making.

CONCLUSIONS:

Findings from this study indicate that experienced nurses utilize several sources of information to inform their intuition. It is apparent that the demands on nurses in response to pandemics are heightened. Decision-making themes drawn from participants' experiences can to assist nurse educators for training nursing students on decision-making for deteriorating patients and how to manage the potential barriers (e.g., resource constraints, lack of family) associated with caring for patients during these challenging times prior to encountering these issues in the clinical environment. Nurse practice can utilize these findings to increase awareness among experienced nurses on recognizing how pandemic situations can impact to their decision-making capability.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / Clinical Decision-Making / SARS-CoV-2 / COVID-19 / Nurses / Nursing Care Type of study: Prognostic study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0254077

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / Clinical Decision-Making / SARS-CoV-2 / COVID-19 / Nurses / Nursing Care Type of study: Prognostic study / Qualitative research Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2021 Document Type: Article Affiliation country: Journal.pone.0254077