Evaluation of nurses' experiences of a post education program promoting recognition and response to patient deterioration: Phase 2, clinical coach support in practice

Nurse Educ Pract. 2020 Jul:46:102835. doi: 10.1016/j.nepr.2020.102835. Epub 2020 Jul 4.

Abstract

Front-line nurses providing around the clock care are pivotal to the identification, recognition, and response to patient deterioration. However, there is growing evidence that patient deterioration indicators are poorly managed and not escalated to rapid response teams (RRTs), contributing to adverse outcomes. Access to effective educational programs has been cited as vital in optimising nurses' recognition and response to deteriorating patients. Several studies evaluated educational programs, but have not explored nurses' experiences of engaging in patient deterioration events post attendance. Participants in a multimodal education program (DeTER) were invited to attend a series of focus groups three months post workshop as phase two of an overall study. A convenience sample of 22 acute care nurses was recruited. A qualitative descriptive design incorporating focus groups and thematic analysis was used to evaluate participants' experiences of engaging with the RRT during patient deterioration events and whether clinical coach support in practice influenced their recognition and response. Four themes were identified within the data, categorised as enhanced confidence, effective communication, supportive culture, and early response. The importance of an educational model using multimodal strategies, underpinned by coach support and guidance post workshop, was clearly demonstrated to optimise nurses' management of patient deterioration events.

Keywords: Clinical coach support; Continuing education; Patient deterioration; Patient safety.

MeSH terms

  • Clinical Deterioration*
  • Critical Care Nursing* / education
  • Education, Nursing, Graduate*
  • Focus Groups
  • Hospital Rapid Response Team
  • Humans
  • Nursing Diagnosis
  • Nursing Education Research
  • Nursing Evaluation Research
  • Qualitative Research
  • Students, Nursing* / psychology