RESUMEN
ABSTRACT: This innovative teaching strategy sought to evaluate authentic literature as the primary textbook in a nursing theory course. Arts-based pedagogy can potentiate students' development of critical thinking skills, which are necessary for sound clinical judgment. At the end of the course, students responded to an online survey to better understand their experience of using authentic literature in nursing. Students reported a high level of agreement on the interconnectedness of themes in the authentic literature with the course purpose and content. Authentic literature provided a contextual perspective for analysis, debate, and formation of clinical nursing judgment.
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Bachillerato en Enfermería , Estudiantes de Enfermería , Humanos , Teoría de Enfermería , Práctica Profesional , PensamientoRESUMEN
BACKGROUND: An examination of invasive procedure cancellations found that the lack of pre-procedural oral screening was a preventable cause, for children with congenital heart disease. The purpose of this study was to implement an oral screening tool within the paediatric cardiology clinic, with referral to paediatric dental providers for positive screens. The target population were children aged ≥6 months to <18 years old, being referred for cardiac procedures. METHODS: The quality implementation framework method was used for this study design. The multi-modal intervention included education, audit and feedback, screening guidelines, environmental support, and interdisciplinary collaboration. Baseline rates for oral screenings were determined by retrospective chart audit from January 2018 to January 2019 (n = 211). Provider adherence to the oral screening tool was the outcome measure. Positive oral screens, resulting in referral to the paediatric dental clinic, were measured as a secondary outcome. Provider adherence rates were used as a process measure. RESULTS: Data collected over 14 weeks showed a 29% increase in documentation of oral screenings prior to referral, as compared to the retrospective chart audit. During the study period, 13% of completed screenings were positive (n = 5). Provider compliance for the period was averaged at 70% adherence. CONCLUSION: A substantial increase in pre-procedural oral screenings by paediatric cardiologists was achieved using the quality implementation framework and targeted interventions.
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Cardiólogos , Cardiopatías Congénitas , Niño , Cardiopatías Congénitas/diagnóstico , Humanos , Lactante , Pediatras , Derivación y Consulta , Estudios RetrospectivosRESUMEN
The notion that human error should not be tolerated is prevalent in both the public and personal perception of the performance of clinicians. However, researchers in other safety-critical domains have long since abandoned the quest for zero defects as an impractical goal, choosing to focus instead on the development of strategies to enhance the ability to recover from error. This paper presents a cognitive framework for the study of error recovery, and the results of our empirical research into error detection and recovery in the critical care domain, using both laboratory-based and naturalistic approaches. Both attending physicians and residents were prone to commit, detect and recover from errors, but the nature of these errors was different. Experts corrected the errors as soon as they detected them and were better able to detect errors requiring integration of multiple elements in the case. Residents were more cautious in making decisions showing a slower error recovery pattern, and the detected errors were more procedural in nature with specific patient outcomes. Error detection and correction are shown to be dependent on expertise, and on the nature of the everyday tasks of the clinicians concerned. Understanding the limits and failures of human decision-making is important if we are to build robust decision-support systems to manage the boundaries of risk of error in decision-making. Detection and correction of potential error is an integral part of cognitive work in the complex, critical care workplace.