Bridging the gap between problem recognition and treatment: the use of proactive work behaviors by experienced critical care nurses

Policy, Politics & Nursing Practice
Linda C Hughes

Abstract

Delayed access to physicians has been identified as a factor in preventable adverse patient events during hospitalization. Nurses as front-line providers are well positioned to provide a timely response to the needs of patients. Yet legal regulations and hospital policies limit the actions nurses can initiate without physician authorization. The purpose of this qualitative study was to describe what experienced critical care nurses do when they recognize a problem that warrants treatment but lack physician authorization to intervene. The 13 nurses who participated in this study bridged the gap between problem recognition and treatment by communicating proactively, being persistent, running interference for other nurses, and, in some situations, acting without physician authorization. Revising legal regulations and hospital policies to incorporate greater acknowledgment of the overlapping functions between medicine and nursing and recognition of the knowledge and expertise of experienced nurses may be important in reducing unnecessary treatment delays during hospitalization.

References

Jan 1, 1987·Image--the Journal of Nursing Scholarship·P A PrescottA K Jacox
Apr 2, 1998·BMJ : British Medical Journal·E Coiera, V Tombs
Feb 24, 2001·The Journal of Nursing Administration·M A BlegenC J Goode
Feb 22, 2003·Nursing Outlook·Marlene Kramer, Claudia E Schmalenberg
Jan 23, 2004·The Journal of Nursing Administration·Linda McGillis HallGeorge H Pink
Dec 4, 2004·The Journal of Nursing Administration·Janice StewartDianne Tapp
Jun 4, 2005·Quality & Safety in Health Care·K H RobertsD Van Stralen
Mar 1, 2006·Critical Care Medicine·Derek C AngusUNKNOWN Committee on Manpower for Pulmonary and Critical Care Societies (COMPACCS)
Oct 5, 2006·Intensive Care Medicine·Claudio SandroniMassimo Antonelli
Apr 7, 2007·Critical Care Medicine·Bradford D WintersPeter J Pronovost
Jan 4, 2008·The New England Journal of Medicine·Paul S ChanUNKNOWN American Heart Association National Registry of Cardiopulmonary Resuscitation Investigators
Feb 21, 2008·JAMA : the Journal of the American Medical Association·Mary Ann PeberdyUNKNOWN National Registry of Cardiopulmonary Resuscitation Investigators
Sep 10, 2008·Archives of Internal Medicine·Leora I HorwitzElizabeth H Bradley
Jul 18, 2009·BMC Medical Research Methodology·Mette Asbjoern NeergaardJens Sondergaard
May 1, 2010·Quality & Safety in Health Care·Kevin J O'LearyM V Williams
May 12, 2010·Policy, Politics & Nursing Practice·Maja Djukic, Christine T Kovner
Mar 18, 2011·The New England Journal of Medicine·Jack NeedlemanMarcelline Harris
Jun 23, 2011·Health·Simon Carmel, Denise Baker-McClearn
Jun 24, 2011·Research and Theory for Nursing Practice·Leah L Shever
Sep 29, 2011·Academic Medicine : Journal of the Association of American Medical Colleges·Arthur Garson

❮ Previous
Next ❯

Citations

May 4, 2013·Journal of Emergency Nursing : JEN : Official Publication of the Emergency Department Nurses Association·Jessica CastnerLenore Boris
Mar 5, 2016·Journal of Nursing Management·Min Young KimSeung-Wan Kang
Feb 10, 2016·Global Qualitative Nursing Research·Suegnèt ScholtzChris P H Myburgh

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

Related Papers

The New England Journal of Medicine
E RiversEarly Goal-Directed Therapy Collaborative Group
Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Steven L BernsteinSociety for Academic Emergency Medicine, Emergency Department Crowding Task Force
Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Brian H RoweBrian R Holroyd
© 2021 Meta ULC. All rights reserved