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A literature review: graduate nurses' preparedness for recognising and responding to the deteriorating patient

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  • Amy Purling
  • Lindy King

Abstract

Aims and objectives To explore the research literature that provided data on factors that influence new graduate nurse's preparedness for recognition and response to patient deterioration in the acute care setting. Background Nurses have a significant role in recognising subtle signs of patient deterioration and responding appropriately to prevent adverse events and improve patient outcomes. This pivotal position has often fallen to the new graduate who must be prepared to make high‐consequence decisions in relation to a suspected decline in their patient's condition. Design and methods An integrative review was undertaken. A comprehensive literature search was conducted using online databases, reference lists of key articles and expert advice. Multiple keyword combinations were used. All relevant studies were subsequently appraised for rigour and quality. Seventeen primary research studies drawn from novice and experienced registered nurse experiences emerged as relevant to the review. Results Thematic analysis of the studies provided six major themes related to the aim of the review. Emergent themes were as follows: clinical staff support, lack of nurse experience, overwhelming workload, holistic patient assessment, past experiences and lack of available resources. Conclusions This review highlighted the importance of positive staff support and subsequent confidence building. Graduates then felt able to present effective assessments and less fearful of reprimand when escalating an intervention call. The need for further research to investigate graduate nurses' experiences of recognising and responding to the deteriorating patient emerged. Relevance to clinical practice Realistic workloads and access to supportive experienced staff would allow graduates time to focus on grouping clinical information to understand the ‘total picture’ of the patient. Results indicated undergraduate and hospital in‐service education programmes needed to offer the opportunity to practice reasoning. Complex clinical situations involving patient deterioration through simulation and clinical placement opportunities appeared most useful.

Suggested Citation

  • Amy Purling & Lindy King, 2012. "A literature review: graduate nurses' preparedness for recognising and responding to the deteriorating patient," Journal of Clinical Nursing, John Wiley & Sons, vol. 21(23-24), pages 3451-3465, December.
  • Handle: RePEc:wly:jocnur:v:21:y:2012:i:23-24:p:3451-3465
    DOI: 10.1111/j.1365-2702.2012.04348.x
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    Cited by:

    1. Elizabeth K. Herron, 2018. "New graduate nurses’ preparation for recognition and prevention of failure to rescue: A qualitative study," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(1-2), pages 390-401, January.
    2. Chiew‐Jiat Siah & Fui‐Ping Lim & Siew‐Tiang Lau & Wilson Tam, 2021. "The use of the community of inquiry survey in blended learning pedagogy for a clinical skill‐based module," Journal of Clinical Nursing, John Wiley & Sons, vol. 30(3-4), pages 454-465, February.
    3. Anna Willman & Kaisa Bjuresäter & Jan Nilsson, 2021. "Insufficiently supported in handling responsibility and demands: Findings from a qualitative study of newly graduated nurses," Journal of Clinical Nursing, John Wiley & Sons, vol. 30(1-2), pages 83-92, January.
    4. Carol Della Ratta, 2018. "The art of balance: Preceptors’ experiences of caring for deteriorating patients," Journal of Clinical Nursing, John Wiley & Sons, vol. 27(19-20), pages 3497-3509, October.

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