Care in acute detrioration : nurses' confidence, perceived competence and training needs

Abstract

Background: Mortality from in-patient complications occurs frequently worldwide, including locally. Currently, local nurses use a modified EWS tool to identify and manage patient deterioration. While in the events of mortality, they escalate care through initiating life-support measures, and requesting the resuscitation team’s support. Both these processes rely on the nurses’ knowledge, confidence and competence in identifying and managing acute deterioration. Evidence suggests that the previously mentioned may not always be up to par. Objectives: This study aimed to evaluate nurses’ perceived level of confidence and competence in the identification and management of acute deterioration. Together with their identified needs for further training in this sector. Design: A descriptive, cross-sectional design, characterised by data collection through a self-designed online questionnaire. Participants: Staff nurses working in adult medical and surgical wards within a local hospital, who do not provide specialised, long-term or high-dependency care. Methods: The whole population of nurses working in the medical and surgical units were recruited to participate, therefore no sampling was required. An email including information and the questionnaire’s link was distributed to the participants by selected intermediaries. Collected data was input and analysed on SPSS version 28. Results: Following four reminders, a total of 39.4% of the questionnaires were returned. Findings showed that nurses’ perceived themselves as confident and competent in both the identification and management of acute deterioration. Furthermore, needs for higher levels of life-support and retraining were identified, especially in using Styner’s ‘ABCDE’ approach. Another noticeable finding was the strong positive correlation between nurses’ perceived confidence and perceived competence. Conclusion: Despite the high perceived confidence and competence levels, a high interest in further training was evident. Indicating the nurses’ high regard for continuous professional development. Hence more frequent and in-depth courses should be made available to further improve the delivered level of patient care.