The Experience of Nurses Who Use Automated Early Warning Systems Technology in Clinical Practice

Abstract

Failure to rescue (FTR) outcomes may be one consequence of the relationship be-tween healthcare provider behaviors and attitudes, organizational factors, and environ-mental factors that intersect to potentially threaten patient safety. Early warning systems (EWS) were designed as surveillance systems to reduce failure to rescue events and avoid morbidity and mortality. Challenges with EWS include lack of standardization, organiza-tional barriers, such as culture and supports, and human factor attributes such as intuition, expertise, and experience. The experience and perceptions of nurses using EWS technolo-gy as it relates to their clinical assessment, critical thinking, and decision-making skills has yet to be undertaken. This study adds to the body of EWS and FTR literature and the broader culture of safety literature in acute care environments. The purposes of this exploratory qualitative descriptive study was to explore the experiences of nurses using EWS in acute care practice settings and how they perceive it impacts on their critical thinking and clinical decision-making processes. The study identi-fied three informative findings: a) EWS has added value particularly with novice nurses or nurses new to practice settings, b) EWS provides benefits to nurses working in acute clinical environments that experience high volumes and high acuity of patients by alerting or reminding them about potential FTR situations, and c) Existing EWS may require mod-ification to improve adequacy, reduce redundancy, and reduce alarm fatigue. Based on the evidence reviewed, a qualitative study to increase our understanding of the experi-ence of nurses and their perception of the impact of EWS and related technology on their critical thinking and other nursing practice processes has the potential to contribute to a wider evaluation of EWS systems and to improve patient outcomes.