Clinical Judgments of Experienced ICU Nurses Preparing for Emergency Admissions

Abstract

　Aims: To elucidate the clinical judgments of experienced Intensive Care Unit (ICU) nurses who are preparing for emergency admissions of patients from the emergency outpatient clinic.

　Methods: Semi-structured interviews of nurses with at least four years of ICU experience in hospitals in A Prefecture were conducted. The nurses were asked about their thoughts and actions between the time they received notification of an emergency admission to the ICU of a patient from the emergency outpatient clinic and the time the patient is admitted to the ICU. The content of their responses was analyzed using a qualitative inductive method.

　Results: Nine major categories were identified as clinical judgments of experienced ICU nurses, including Linking information and making inferences about the critical state of the patient, Conjecture about the direction of intensive care the patient will receive, Determining the items that may be needed for management of intensive care after admission, and Designing the arrangement of items so that care can be carried out smoothly.

　Discussion: The characteristics of clinical judgments of experienced ICU nurses are thought to include conjecturing the critical state of patients while linking small amounts of information and determining the emergency status and level of severity, and predicting the direction of intensive care the patient will receive.