The effect of a web-based educational program on nursing practice in recognising and responding to deteriorating ward patients: A qualitative evaluation study

• Published in: Collegian (Royal College of Nursing, Australia) Vol. 24; no. 5; pp. 455 - 461
• Main Authors: Liaw, Sok Ying, Ping Lim, Eunice Ya, Wong, Lai Fun, Yin Ho, Jasmine Tze, Mordiffi, Siti Zubaidah, Leng Ang, Sophia Bee, Chua, Wei Ling, Ang, Emily Neo Kim
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.10.2017
• Subjects: Clinical deterioration; Clinical practice; Nursing education; Rapid response system; Web-based program; Rapid response system; Nursing education; Clinical deterioration; Clinical practice; Web-based program
• ISSN: 1322-7696
• DOI: 10.1016/j.colegn.2016.09.008

There is an international interest for optimising nursing performance in detecting and responding to deteriorating patients. To explore nurses’ perspective of a web-based educational program on their clinical practice in recognising and responding to deteriorating ward patients. This study used an exploratory descriptive qualitative study design. Five focus groups were conducted with 26 nurses who encountered deteriorating patients in their workplace after they completed the 3-h web-based educational program on the care of patients with clinical deterioration. Interview transcripts were analysed using thematic analysis. Four themes emerged on the impact of the educational program on nurses’ clinical practice: ‘Understanding vital sign changes’ heightened the nurses’ awareness of performing vital signs monitoring; ‘Application of knowledge in patient assessment’, in which the nurses were able to perform physical assessments; ‘Communicating deterioration’ using the communication and triggering tool that has both positive and negative impacts in escalating clinical deterioration; ‘Optimising effectiveness’ of the educational program could include better accessibility, protected time, an element of assessment, and a hands-on simulation. Across themes, the participants reported barriers that inhibited their practice. A web-based educational program on clinical deterioration has a significant potential to empower nurses in caring for deteriorating ward patients. Future implications were identified from the reported barriers to optimise nurses’ roles. These include the availability of electronic systems for continuous vital signs monitoring, strategies to help nurses cope with stressors, and education to highlight the importance of the ‘serious concern’ criterion for triggering early deterioration.