Christina Chipeta, Peng Lingli, Musa Nget, Chifundo Benedicto Thamala
{"title":"初级护士识别和应对临床恶化能力的相关因素:马拉维三级医院横断面研究","authors":"Christina Chipeta, Peng Lingli, Musa Nget, Chifundo Benedicto Thamala","doi":"10.1111/jep.14243","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Rationale</h3>\n \n <p>Recognising and responding swiftly to patient deterioration is critical for preventing adverse events. Junior nurses play a vital role in identifying the signs of clinical deterioration and initiating interventions. No prior studies have assessed junior nurses’ abilities to manage clinical deterioration in Malawi.</p>\n </section>\n \n <section>\n \n <h3> Objectives</h3>\n \n <p>This study aimed to assess junior nurses’ ability to recognise and respond to clinical deterioration in Malawian tertiary hospitals and identify associated factors.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The institutional based cross-section study design was used which included 322 junior nurses across all departments of four tertiary hospitals in Malawi (November–December 2023). Data collection utilised a questionnaire for clinical deterioration recognition and response ability in junior nurses. Chi-square, Fisher's exact, and logistic regression tests were used for data analysis.</p>\n </section>\n \n <section>\n \n <h3> Findings</h3>\n \n <p>Junior nurses achieved a median score of 71 with an interquartile range of 68–75 on the clinical deterioration questionnaire. According to the study, nurses with more work experience, those who worked in intensive care units, and those who participated in discussions about clinical deterioration had better scores. In contrast, nurses with less than 1 year of experience were 5.5 times more likely to struggle with recognising and responding to clinical deterioration than those with 5 years of experience (<i>OR</i>: 5.506, <i>p</i> = 007). Additionally, working in the paediatric department decreased junior nurses’ ability to recognise and respond to clinical deterioration six times compared to working in the intensive care unit (OR: 6.068, <i>p</i> = 0.018). Furthermore, junior nurses who had never engaged in discussions related to clinical deterioration had a seven times higher likelihood of poor ability to recognise and respond to clinical deterioration (OR = 6.954, <i>p</i> = 0.005).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>This study highlights the need for specialised training programmes related to clinical deterioration that incorporate active learning, such as clinical scenarios and practical applications, along with mentorship initiatives to enhance junior nurses’ skills and confidence in recognising and responding to clinical deterioration.</p>\n </section>\n </div>","PeriodicalId":15997,"journal":{"name":"Journal of evaluation in clinical practice","volume":"31 1","pages":""},"PeriodicalIF":2.1000,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors Associated With Junior Nurses Ability to Recognise and Respond to Clinical Deterioration: A Cross-Sectional Study in Tertiary Hospitals in Malawi\",\"authors\":\"Christina Chipeta, Peng Lingli, Musa Nget, Chifundo Benedicto Thamala\",\"doi\":\"10.1111/jep.14243\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Rationale</h3>\\n \\n <p>Recognising and responding swiftly to patient deterioration is critical for preventing adverse events. Junior nurses play a vital role in identifying the signs of clinical deterioration and initiating interventions. No prior studies have assessed junior nurses’ abilities to manage clinical deterioration in Malawi.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>This study aimed to assess junior nurses’ ability to recognise and respond to clinical deterioration in Malawian tertiary hospitals and identify associated factors.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>The institutional based cross-section study design was used which included 322 junior nurses across all departments of four tertiary hospitals in Malawi (November–December 2023). Data collection utilised a questionnaire for clinical deterioration recognition and response ability in junior nurses. Chi-square, Fisher's exact, and logistic regression tests were used for data analysis.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Findings</h3>\\n \\n <p>Junior nurses achieved a median score of 71 with an interquartile range of 68–75 on the clinical deterioration questionnaire. According to the study, nurses with more work experience, those who worked in intensive care units, and those who participated in discussions about clinical deterioration had better scores. In contrast, nurses with less than 1 year of experience were 5.5 times more likely to struggle with recognising and responding to clinical deterioration than those with 5 years of experience (<i>OR</i>: 5.506, <i>p</i> = 007). Additionally, working in the paediatric department decreased junior nurses’ ability to recognise and respond to clinical deterioration six times compared to working in the intensive care unit (OR: 6.068, <i>p</i> = 0.018). Furthermore, junior nurses who had never engaged in discussions related to clinical deterioration had a seven times higher likelihood of poor ability to recognise and respond to clinical deterioration (OR = 6.954, <i>p</i> = 0.005).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>This study highlights the need for specialised training programmes related to clinical deterioration that incorporate active learning, such as clinical scenarios and practical applications, along with mentorship initiatives to enhance junior nurses’ skills and confidence in recognising and responding to clinical deterioration.</p>\\n </section>\\n </div>\",\"PeriodicalId\":15997,\"journal\":{\"name\":\"Journal of evaluation in clinical practice\",\"volume\":\"31 1\",\"pages\":\"\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-11-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of evaluation in clinical practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/jep.14243\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEALTH CARE SCIENCES & SERVICES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of evaluation in clinical practice","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/jep.14243","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEALTH CARE SCIENCES & SERVICES","Score":null,"Total":0}
Factors Associated With Junior Nurses Ability to Recognise and Respond to Clinical Deterioration: A Cross-Sectional Study in Tertiary Hospitals in Malawi
Rationale
Recognising and responding swiftly to patient deterioration is critical for preventing adverse events. Junior nurses play a vital role in identifying the signs of clinical deterioration and initiating interventions. No prior studies have assessed junior nurses’ abilities to manage clinical deterioration in Malawi.
Objectives
This study aimed to assess junior nurses’ ability to recognise and respond to clinical deterioration in Malawian tertiary hospitals and identify associated factors.
Methods
The institutional based cross-section study design was used which included 322 junior nurses across all departments of four tertiary hospitals in Malawi (November–December 2023). Data collection utilised a questionnaire for clinical deterioration recognition and response ability in junior nurses. Chi-square, Fisher's exact, and logistic regression tests were used for data analysis.
Findings
Junior nurses achieved a median score of 71 with an interquartile range of 68–75 on the clinical deterioration questionnaire. According to the study, nurses with more work experience, those who worked in intensive care units, and those who participated in discussions about clinical deterioration had better scores. In contrast, nurses with less than 1 year of experience were 5.5 times more likely to struggle with recognising and responding to clinical deterioration than those with 5 years of experience (OR: 5.506, p = 007). Additionally, working in the paediatric department decreased junior nurses’ ability to recognise and respond to clinical deterioration six times compared to working in the intensive care unit (OR: 6.068, p = 0.018). Furthermore, junior nurses who had never engaged in discussions related to clinical deterioration had a seven times higher likelihood of poor ability to recognise and respond to clinical deterioration (OR = 6.954, p = 0.005).
Conclusion
This study highlights the need for specialised training programmes related to clinical deterioration that incorporate active learning, such as clinical scenarios and practical applications, along with mentorship initiatives to enhance junior nurses’ skills and confidence in recognising and responding to clinical deterioration.
期刊介绍:
The Journal of Evaluation in Clinical Practice aims to promote the evaluation and development of clinical practice across medicine, nursing and the allied health professions. All aspects of health services research and public health policy analysis and debate are of interest to the Journal whether studied from a population-based or individual patient-centred perspective. Of particular interest to the Journal are submissions on all aspects of clinical effectiveness and efficiency including evidence-based medicine, clinical practice guidelines, clinical decision making, clinical services organisation, implementation and delivery, health economic evaluation, health process and outcome measurement and new or improved methods (conceptual and statistical) for systematic inquiry into clinical practice. Papers may take a classical quantitative or qualitative approach to investigation (or may utilise both techniques) or may take the form of learned essays, structured/systematic reviews and critiques.