Signal detection for pediatric patient deterioration in simulation with nursing students : a mixed methods study

When nurses delay or fail to detect the signals of clinically significant changes during the early stages of disease complication or patient deterioration, it is known as a failure to rescue (FTR). Pediatric patients in the hospital are at risk of being harmed or dying due to FTR. Pediatric patient deterioration detection poses a different challenge because pediatric patients physiologically respond differently from adults. Student nurses are especially challenged in detecting pediatric patient deterioration because adult illness is the primary focus of nursing education. To assess and understand nursing students' pediatric deterioration detection performance, an explanatory sequential mixed method study was conducted with second-semester senior baccalaureate nursing students (n=21). A conceptual framework incorporating concepts from Ericsson et al.'s (1993) Deliberate Practice Theory and Despins et al.'s (2010) Patient Risk Detection Theory guided the study The group had a low sensitivity d' = 1.19 (SD 0.85) to signals of pediatric deterioration and an increased tendency c = -0.03 (SD 0.66) to decide, "Yes, this stimulus is a signal." vital sign type did not significantly affect detection. Student responses were influenced by Nursing School & Life Experiences, Self-Reflection with sub-themes Reflection on the Patient's Status and Reflection of own Abilities and Knowledge Needs, Responder Bias with sub-themes of Going to See the Patient and Not Going to See the Patient, and Sensitivity to Signals. Differences in detection performance corresponded with differences in influencing factors. More research is needed to provide a framework for the methods to improve nursing education for pediatric patient care.

Name thesis:degree_name

Ph. D.

Level thesis:degree_level

Doctoral

Discipline thesis:degree_discipline

Nursing (MU)

Grantor dc:publisher

University of Missouri--Columbia

Year dc:date.issued

2023

Author dc:creator

• Zimpelman, Leslie Turner

Advisor dc:contributor.advisor

• Despins, Laurel

Language dc:language.iso

eng, English

DOI

https://doi.org/10.32469/10355/97012

OAI identifier oai:identifier

oai:mospace.umsystem.edu:10355/97012