1
|
Considine J, Casey P, Omonaiye O, van Gulik N, Allen J, Currey J. Importance of specific vital signs in nurses' recognition and response to deteriorating patients: A scoping review. J Clin Nurs 2024; 33:2544-2561. [PMID: 38454551 DOI: 10.1111/jocn.17099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/11/2023] [Accepted: 02/28/2024] [Indexed: 03/09/2024]
Abstract
AIM(S) To explore the published research related to nurses' documentation and use of vital signs in recognising and responding to deteriorating patients. DESIGN Scoping review of international, peer-reviewed research studies. DATA SOURCES Cumulative Index to Nursing and Allied Health Literature Complete, Medline Complete, American Psychological Association PsycInfo and Excerpta Medica were searched on 25 July 2023. REPORTING METHOD Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. RESULTS Of 3880 potentially eligible publications, 32 were included. There were 26 studies of nurses' vital sign documentation: 21 adults and five paediatric. The most and least frequently documented vital signs were blood pressure and respiratory rate respectively. Seven studies focused on vital signs and rapid response activation or afferent limb failure. Five studies of vital signs used to trigger the rapid response system showed heart rate was the most frequent and respiratory rate and conscious state were the least frequent. Heart rate was least likely and oxygen saturation was most likely to be associated with afferent limb failure (n = 4 studies). CONCLUSION Despite high reliance on using vital signs to recognise clinical deterioration and activate a response to deteriorating patients in hospital settings, nurses' documentation of vital signs and use of vital signs to activate rapid response systems is poorly understood. There were 21studies of nurses' vital sign documentation in adult patients and five studies related to children. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE A deeper understanding of nurses' decisions to assess (or not assess) specific vital signs, analysis of the value or importance nurses place (or not) on specific vital sign parameters is warranted. The influence of patient characteristics (such as age) or the clinical practice setting, and the impact of nurses' workflows of vital sign assessment warrants further investigation. PATIENT OR PUBLIC CONTRIBUTION No Patient or Public Contribution.
Collapse
Affiliation(s)
- Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety Research-Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
| | - Penelope Casey
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety Research-Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
| | - Olumuyiwa Omonaiye
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety Research-Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
| | - Nantanit van Gulik
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
- Centre for Quality and Patient Safety Research-Eastern Health Partnership, Eastern Health, Box Hill, Victoria, Australia
| | - Joshua Allen
- Department of Nursing, School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Victoria, Australia
| | - Judy Currey
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| |
Collapse
|
2
|
Liu J, Zheng H, Lu L, Liu H, Xu X, He W. The impact of patients' hostile attribution bias on aggression in doctor-patient interactions. Heliyon 2024; 10:e23971. [PMID: 38268606 PMCID: PMC10805917 DOI: 10.1016/j.heliyon.2024.e23971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 12/06/2023] [Accepted: 01/01/2024] [Indexed: 01/26/2024] Open
Abstract
Background Doctor-patient conflict is trending in social attention research. However, the existing literature rarely explores whether a patient's hostile attribution bias (HAB) in the doctor-patient interaction affects the aggression level against doctors. Objective This study aimed to explore the relationship and mechanism between different types of HAB and aggression in patients. Method In Study 1, 80 patients completed the word sentence association paradigm for hostility (WSAP-Hostility), and their explicit and implicit aggression levels were measured using the hot sauce paradigm and the single-category implicit association test (SC-IAT), respectively. In Study 2, 63 patients were randomly divided into an experimental (rejection) and a control group. Their state hostile attribution bias (SHAB) was activated through social rejection materials. They completed the SHAB questionnaire and anger expression inventory, and their explicit and implicit aggression levels were measured as in Study 1. Results In both studies, results indicated that patients' trait and state HAB were significantly related to explicit aggression but not implicit aggression. Hostile interpretation positively predicted explicit aggression, whereas benign interpretation had a negative predictive effect on explicit aggression. Patients' anger played a mediating role between SHAB and explicit aggression. Conclusions These findings suggest that patients' HAB affects explicit aggression toward doctors and anger plays a mediating role.
Collapse
Affiliation(s)
- Jie Liu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Hong Zheng
- Changning Mental Health Center Affiliated with East China Normal University, Shanghai, China
| | - Lu Lu
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| | - Hongying Liu
- Hangzhou Kang Sheng Health Consulting Co., Ltd. Hangzhou 310023, China
| | - Xiongwei Xu
- School of Education, Shanghai Normal University, Shanghai, 200234, China
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai, 200234, China
| |
Collapse
|
3
|
Joyce A, Pellatt R, Ranse J, Doumany A, Hall E, Sweeny A, Keijzers G. Occupational violence in a tertiary emergency department: A retrospective descriptive study. Australas Emerg Care 2023; 26:346-351. [PMID: 37331906 DOI: 10.1016/j.auec.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 05/10/2023] [Accepted: 05/23/2023] [Indexed: 06/20/2023]
Abstract
OBJECTIVE Occupational violence in emergency departments (EDs) impacts staff and patients. Most hospitals have a response mechanism called a 'Code Black' or similar. We aimed to determine the incidence of Code Black activations in a tertiary ED and describe contributory factors, management strategies and adverse events. METHODS Descriptive study in a tertiary ED in South-East Queensland in 2021. Adult patients for who a Code Black had been activated were eligible. Data were obtained from a prospectively collected Code Black database, supplemented with retrospective electronic medical records. RESULTS There were 386 Code Black events. The incidence of Code Black activation was 11.0 per 1000 adult ED presentations. Individuals requiring Code Black activation were 59.6 % male with a mean age of 40.9 years. The primary diagnosis was mental illness related in 55.1 %. Alcohol was a suspected factor in 30.9 %. When Code Black activation occurred, median length of stay increased. Restraint including physical, chemical or both were used in 54.1 % of Code Blacks. CONCLUSION Occupational violence occurs at a three-fold greater incidence within this ED than reported elsewhere. This study reinforces other literature suggesting an increase in occupational violence, demonstrating the need for dedicated preventative strategies for patients at risk of agitation.
Collapse
Affiliation(s)
- Alexander Joyce
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
| | - Richard Pellatt
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; LifeFlight Retrieval Medicine, Brisbane, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Jamie Ranse
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
| | - Amy Doumany
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Emma Hall
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Amy Sweeny
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| | - Gerben Keijzers
- Department of Emergency Medicine, Gold Coast University Hospital, Gold Coast, Queensland, Australia; Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia; School of Medicine, Griffith University, Gold Coast, Queensland, Australia
| |
Collapse
|
4
|
Woon C. A Literature Review: Violence and Aggression in Neuroscience Nursing. J Neurosci Nurs 2023; 55:60-64. [PMID: 36857134 DOI: 10.1097/jnn.0000000000000692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
ABSTRACT BACKGROUND: Violence and aggression is commonly encountered in nursing worldwide and is an increasing concern, although it is largely underreported by staff. Violence and aggression can take many forms, from verbal and physical abuse to sexual assault. This study aims to define agitation, violence, and aggression and to explore the prevalence of violence and aggression among neuroscience patients. This review also examines why violence and aggression occurs for neuroscience patients and to determine the effects on the patients, the environment, and the nursing staff. METHODS: A review of articles was conducted using CINAHL, PubMed, the Cochrane Database, and Google Scholar between 2012 and 2022. DISCUSSION: Agitation can escalate to violence and aggression. The reasons a neuroscience patient may become agitated are multifactorial. An injury to the brain may not cause agitation; however, the effect on the frontal lobe, hypothalamus, and hippocampus may cause a lack of self-control, impulsivity, an inability to control emotions, and an uncontrolled release of hormones, leading to a heightened sympathetic response. The effects of violence and aggression can be detrimental to the patient and include isolation, increased sedation, reduced observations, and even death. The effects on the nurse are profound including a decline in productivity at work, an increased risk of drug errors, and posttraumatic stress disorder or burnout as longer-term consequences. CONCLUSION: Violence and aggression is commonly experienced within neuroscience nursing, and the contributing factors are multifactorial. The effects for the patients and staff can be profound, and this is why prevention of agitation is fundamental to ensure the safety and retention of nursing staff.
Collapse
Affiliation(s)
- Caroline Woon
- Questions or comments about this article may be directed to Caroline Woon at . C.W. is a Neuroscience Clinical Nurse Educator, Wellington Hospital, Wellington, New Zealand
| |
Collapse
|
5
|
Tyler V, Aggar C, Grace S, Doran F. Nurses and midwives reporting of workplace violence and aggression: an integrative review. Contemp Nurse 2022; 58:113-124. [PMID: 35535431 DOI: 10.1080/10376178.2022.2070519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: The experience of workplace violence and aggression is a common occurrence among the nursing and midwifery workforce, however, it is largely under-reported. Reasons for underreporting are not well understood.Aim: To review factors that influence nurses' and midwives' reporting of workplace violence and aggression from patients and visitors in hospital inpatient settings.Method: In this integrative review papers were identified through a search of electronic databases Embase, Emcare, PsychInfo, Medline, and CINAHL for literature between 2009 and 2020.Findings: Five papers met the inclusion criteria. Three themes were identified which influence reporting: organisational culture; accepting violence as part of the job; and type of violence.Discussion: Workplace policies supported by management and education programmes are required to improve the reporting of workplace violence and aggression by nurses and midwives.Conclusion: Workplace violence and aggression is under-reported by nurses and midwives in hospital inpatient settings. Reporting systems are not valued and nurses have come to accept workplace violence and aggression. Further research is required to explore strategies to improve workplace violence and aggression reporting culture and assess current education programmes using validated tools.
Collapse
Affiliation(s)
- Vanessa Tyler
- Faculty of Health, Southern Cross University, Lismore, Australia
| | - Christina Aggar
- Faculty of Health, Southern Cross University, Lismore, Australia
| | - Sandra Grace
- Faculty of Health, Southern Cross University, Lismore, Australia
| | - Frances Doran
- Faculty of Health, Southern Cross University, Lismore, Australia
| |
Collapse
|
6
|
Kleissl-Muir S, Raymond A, Rahman MA. Incidence and factors associated with substance abuse and patient-related violence in the emergency department: A literature review. Australas Emerg Care 2018; 21:159-170. [DOI: 10.1016/j.auec.2018.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/29/2022]
|
7
|
Nikathil S, Olaussen A, Symons E, Gocentas R, O'Reilly G, Mitra B. Increasing workplace violence in an Australian adult emergency department. Emerg Med Australas 2017; 30:181-186. [DOI: 10.1111/1742-6723.12872] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 07/03/2017] [Accepted: 08/03/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Shradha Nikathil
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
| | - Alexander Olaussen
- Department of Community Emergency Health and Paramedic Practice; Monash University; Melbourne Victoria Australia
- Emergency and Trauma Centre; The Alfred Hospital, Melbourne; Victoria Australia
- National Trauma Research Institute; The Alfred Hospital; Melbourne Victoria Australia
| | - Evan Symons
- Department of Psychiatry; The Alfred Hospital; Melbourne Victoria Australia
| | - Robert Gocentas
- Emergency and Trauma Centre; The Alfred Hospital, Melbourne; Victoria Australia
| | - Gerard O'Reilly
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
- Emergency and Trauma Centre; The Alfred Hospital, Melbourne; Victoria Australia
- National Trauma Research Institute; The Alfred Hospital; Melbourne Victoria Australia
| | - Biswadev Mitra
- Department of Epidemiology and Preventive Medicine; Monash University; Melbourne Victoria Australia
- Emergency and Trauma Centre; The Alfred Hospital, Melbourne; Victoria Australia
- National Trauma Research Institute; The Alfred Hospital; Melbourne Victoria Australia
| |
Collapse
|