Journal of Professional Nursing

Applied cognitive task analysis methodology: Fundamental cognitive skills surgical nurses require to manage patient deterioration

He kaupapa tikanga tātaritanga mahi hirikapo: Ko ngā pūkenga hirikapo me mātua whai ngā tapuhi poka tinana hei whakahaere tika i te tūroro kua taumahatia

Dianne Marshall, PhD, RN, Senior Lecturer, School of Nursing
Mary Finlayson, PhD, RN, Adjunct Professor, College of Nursing & Midwifery

Reference:  Marshall, D. & Finlayson, M. (2022). Applied cognitive task analysis methodology: Fundamental cognitive skills surgical nurses require to manage patient deterioration. Nursing Praxis in Aotearoa New Zealand, 38(1), 25-37. https://doi.org/10.36951/27034542.2022.04 

 

Abstract:

Abstract
This study’s aims were twofold: firstly, to identify the cognitive skills required of surgical nurses to rescue the deteriorating patient; and secondly, to elicit insight into the potential errors in decision-making inexperienced nurses commonly make in the same situation. An exploratory qualitative design used applied cognitive task analysis. A series of three in-depth interviews with six experienced surgical nurses were employed to collect the data. Applied cognitive task analysis interviews are sequential to identify different aspects of expert knowledge: the task diagram interview; the knowledge audit interview; and the simulation interview. Five difficult cognitive demands were identified when a patient is deteriorating: early recognition of physiological deterioration; confirming physiological deterioration; initiating rescue; securing medical assistance; and rescuing the patient. Nurses require the following cognitive skills to respond effectively to these cognitive demands: decision-making; leadership and management; patient advocacy; situation awareness; and planning. Educators should be aware of these cognitive demands and the specific cognitive skills required to manage patient deterioration and design initiatives to help accelerate nurses' cognitive expertise and consequently reduce errors. The study also highlights the importance of adequate shift coverage with highly skilled nursing staff.

Ngā ariā matua
E rua ngā whāinga o tēnei rangahau: tuatahi, kua tautohutia ngā pūkenga hirikapo me mātua whai ngā tapuhi taiwhanga poka tinana hei whakarauora i te tūroro kua taumahatia; tuarua, kia kitea he māramatanga mō ngā hapa tērā pea ka pā pūputu i roto i te whiriwhiri take a ngā tapuhi tauhou i ngā āhuatanga ōrite. I whakamahia te tātaritanga mahi hirikapo tūturu i tētahi hoahoatanga tūhura inekounga. I whakamahia ētahi uiuinga hōhonu e toru ki ētahi tapuhi poka tinana tokoono tautōhito hei kohi i ngā raraunga. I whai tētahi o ngā uiuinga tātaritanga mahi hirikapo tūturu i tētahi atu, hei tautohu i ngā momo mōhiotanga mātanga: te uiuinga hoahoa mahinga; te uiuinga mōhiotanga arotake; me te uiuinga whakataruna. E rima ngā mahi hirikapo uaua i tautohutia, i te wā e taumahatia ana tētahi tūroro: te kite wawe i te hēnga o te tinana; te whakaū i taua hēnga o te tinana; te tīmata ki te whakarauora; te rapu āwhina tākuta; me te whakarauora i te tūroro. Me mātua whai ngā tapuhi i ngā pūkenga e whai ake nei hei urupare ki ētahi karanga hirikapo: te whakatau take; te hautū me te whakahaere; te tū hei kaikōrero mō te tūroro; te mārama ki ngā āhuatanga o te wā; me te whakamahere. Me mātua mōhio ō rātou kaiako ki ēnei pūtake hirikapo me ngā pūkenga hirikapo motuhake e hiahiatia ana hei whakahaere i te taumahatanga tūroro, me te hoahoa tikanga hei whakapakari wawe i ngā pūkenga hirikapo, hei kaupare hoki i ngā hapa. Kei tēnei rangahau hoki ka kitea he mea nui kia maha ngā kaimahi mō ia wā mahi, kia whai pūkenga tiketike hoki ngā kaimahi.

Keywords / Ngā kupu matua
cognitive task analysis/te tātaritanga mahi hirikapo tūturu; cognitive skills/ngā pūkenga hirikapo; decision-making/te whakatau take; deteriorating patient/te tūroro e taumahatia ana; surgical nursing/te tapuhi poka tinana

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