The clinical surveillance process as carried out by expert nurses in a critical care context: A theoretical explanation

Intensive Crit Care Nurs. 2018 Feb;44:24-30. doi: 10.1016/j.iccn.2017.07.010. Epub 2017 Aug 30.


Background: Nursing Science presents surveillance as an indispensable component of patient safety. Although the literature defines surveillance fully, its implementation is not well understood.

Aim: This research aims to formulate a theoretical explanation of the surveillance process that expert nurses employ in critical care.

Method: To develop the theoretical explanation for the surveillance process of critical care nurses, Strauss and Corbin's (1998) grounded theory approach and Think Aloud Method (Fonteyn et al., 1993) were used with fifteen expert critical care nurses (n=15).

Findings: Surveillance in critical care is a continual process of collaborative vigilance that starts with the thought process and behaviour related to data collection, analysis and interpretation. The surveillance process comprises five key elements: 1) Managing the risk of complications; 2) Collecting data; 3) Detecting a problem; 4) Making a decision and 5) Working in synergy.

Conclusion: In developing a theoretical explanation, this research leads to an understanding of the surveillance process performed by expert nurses in a critical care context.

Keywords: Critical care; Early detection; Expert nurse; Grounded theory; Intensive care; Process; Risk management; Surveillance; Vigilance.

MeSH terms

  • Adult
  • Critical Care Nursing / methods*
  • Decision Making*
  • Female
  • Grounded Theory
  • Humans
  • Male
  • Middle Aged
  • Nursing Process / standards*
  • Qualitative Research
  • Workforce