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"The purpose of this study was to clarify why nursing students did not recognize the patient's needs while checking an infusion" Closset et al (2021).
IV site check failed to identify other care needs

Abstract:

Background: Novice nurses are often unable to watch their surroundings closely when concentrating on their work or recognize them even when observing them closely. However, factors behind this have not been previously explored.

Objectives: The purpose of this study was to clarify why nursing students did not recognize the patient’s needs while checking an infusion.

Design: A comparative, descriptive design study.

Settings: The mock hospital room was set up in a training room of the School of Nursing, University A using partitions. The participants checked an infusion under experimental conditions, and we confirmed whether they recognized the patient’s needs, which were signs of discomfort such as “uncomfortable posture,” “disheveled pajamas,” and “creased sheets.”

Participants: A total of 43 students participated, including second- and third-year students of the School of Nursing, University A.

Methods: The subjects confirmed in an interview whether they had recognized the needs. Their observational behaviors toward the patient and surroundings were measured with an eye mark recorder. Working memory capacity and mental load were measured with Japanese versions of Reading Span Test (RST) and NASA Task Load Index (NASA-TLX).

Results: Seventeen students recognized the patient’s needs. Twelve (70.6%) recognized them when entering the room, with no significant differences in their watching behaviors between the Cognitive and Non-cognitive Groups. RST results were significantly high in Non-cognitive Group (P < .02), and only temporal demand among the sub-items of NASA-TLX presented high.

Conclusions: The nursing students who did not recognize the patient’s needs while checking an infusion were watching the patient in the same way as the students who did recognize the patient’s needs. We presumed that the factors for being unable to recognize were an over-focus on checking on infusion and time pressure.

Reference:

Matsushima M, Kadohama H. Factors behind why nursing students do not recognize patient needs occurring while confirming intravenous infusion even when they observe them: A comparative descriptive design study. Nurse Educ Today. 2021 Jun;101:104886. doi: 10.1016/j.nedt.2021.104886. Epub 2021 Apr 8. PMID: 33862412.

Comments from IVTEAM
Comments from IVTEAM
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IV site checks are an important component of nursing care. The authors discovered the when student nurses checked IV sites they did not identify additional patient care needs such as "uncomfortable posture," "disheveled pajamas," and "creased sheets.

This is an interesting outcome of the potential to over-focus on perceived high priority tasks within nursing; and is a lesson to all that the specialism of infusion therapy should strengthen its procedural links with traditional approaches to nursing, such as the nursing process. Interested in the VIP score for checking IV sites?

This article demonstrates how the VIP score and bundles support clinically indicated replacement of peripheral IV catheters. Click here to listen to Andrew Jackson delivering an update on VIP score monitoring of peripheral IV sites.