Perception of clinical deterioration cues among medical-surgical nurses.
AIM
To examine medical-surgical nurses' capacity and tendency to perceive cues indicating clinical deterioration and nursing characteristics influencing deterioration cue perception.


DESIGN
Cross-sectional, explorative study design.


METHODS
Data were collected over 10 weeks between September-November 2017. Medical-surgical nurses completed an online survey consisting of a demographic questionnaire, the Occupational Fatigue, Exhaustion Recovery scale and 50 detection trials. Descriptive statistics and statistical tests were used to describe and interpret data.


FINDINGS
A significant association was found between nurses' capacity and tendency to perceive deterioration cues. As nurses' capacity to perceive deterioration cues increased, nurses were more likely to classify patient cues as indicators of deterioration. Fatigue, education, and certification were not identified as characteristics associated with deterioration cue perception. However, experience was observed to significantly influence nurses' capacity to perceive deterioration cues based on levels of skills acquisition.


CONCLUSION
Study findings imply that future research should be directed at determining whether other individual factors and organizational system dynamics influence deterioration cue perception.


IMPACT
To better understand how nurses perceive deterioration cues, this study integrated concepts from the Situation Awareness model and Signal Detection Theory. Novice, advanced beginner and competent nurses were found to have a lower capacity to perceive deterioration cues compared with proficient and expert nurses. With simulation increasingly being used as a primary teaching modality in nursing, the development of a simulation-based signal detection training intervention may be beneficial in enhancing deterioration cue perception.
['Orique|Sabrina B|SB|https://orcid.org/0000-0001-8962-4044', 'Despins|Laurel|L|https://orcid.org/0000-0001-6523-5765', 'Wakefield|Bonnie J|BJ|', 'Erdelez|Sanda|S|', 'Vogelsmeier|Amy|A|']
D000328:Adult D001291:Attitude of Health Personnel D000075902:Clinical Deterioration D003430:Cross-Sectional Studies D003463:Cues D005260:Female D006801:Humans D008297:Male D000069469:Medical-Surgical Nursing D008875:Middle Aged D009741:Nursing Staff, Hospital
clinical deterioration nurses nurses cue perception education situation awareness signal detection nursing psychological