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A survey of Malaysian Critical Intensive Care Unit nurses' awareness of patients' transition experiences (PE) and transitional care practice (TCP)

Ludin SM, Parker S, Arbon P

Intensive Crit Care Nurs, 2014 Aug;30(4):196-203.
PMID: 24534582 DOI: 10.1016/j.iccn.2013.12.006

Preparation of critically ill patients throughout their transition experiences in Critical Intensive Care Units (CICU) and following discharge can impact upon their recovery. However, there is little research addressing critical care nurses' awareness of patients' transition experiences.
Patients' transition in the intensive care units: concept analysis

Ludin SM, Arbon P, Parker S

Intensive Crit Care Nurs, 2013 Aug;29(4):187-92.
PMID: 23727138 DOI: 10.1016/j.iccn.2013.02.001

Adequate preparation of critically ill patients throughout their transition experience within and following discharge from the Intensive Care Unit is an important element of the nursing care process during critical illness. However, little is known about nurses' perspectives of, and engagement in, caring for critically ill patients during their transition experiences.
Clinical Activity Monitoring System (CATS): An automatic system to quantify bedside clinical activities in the intensive care unit

Guo P, Chiew YS, Shaw GM, Shao L, Green R, Clark A, et al.

Intensive Crit Care Nurs, 2016 Dec;37:52-61.
PMID: 27401048 DOI: 10.1016/j.iccn.2016.05.003

Monitoring clinical activity at the bedside in the intensive care unit (ICU) can provide useful information to evaluate nursing care and patient recovery. However, it is labour intensive to quantify these activities and there is a need for an automated method to record and quantify these activities. This paper presents an automated system, Clinical Activity Tracking System (CATS), to monitor and evaluate clinical activity at the patient's bedside. The CATS uses four Microsoft Kinect infrared sensors to track bedside nursing interventions. The system was tested in a simulated environment where test candidates performed different motion paths in the detection area. Two metrics, 'Distance' and 'Dwell time', were developed to evaluate interventions or workload in the detection area. Results showed that the system can accurately track the intervention performed by individual or multiple subjects. The results of a 30-day, 24-hour preliminary study in an ICU bed space matched clinical expectations. It was found that the average 24-hour intervention is 22.0minutes/hour. The average intervention during the day time (7am-11pm) is 23.6minutes/hour, 1.4 times higher than 11pm-7am, 16.8minutes/hour. This system provides a unique approach to automatically collect and evaluate nursing interventions that can be used to evaluate patient acuity and workload demand.
Does good critical thinking equal effective decision-making among critical care nurses? A cross-sectional survey

Ludin SM

Intensive Crit Care Nurs, 2018 Feb;44:1-10.
PMID: 28663105 DOI: 10.1016/j.iccn.2017.06.002

BACKGROUND: A critical thinker may not necessarily be a good decision-maker, but critical care nurses are expected to utilise outstanding critical thinking skills in making complex clinical judgements. Studies have shown that critical care nurses' decisions focus mainly on doing rather than reflecting. To date, the link between critical care nurses' critical thinking and decision-making has not been examined closely in Malaysia.
AIM: To understand whether critical care nurses' critical thinking disposition affects their clinical decision-making skills.
METHOD: This was a cross-sectional study in which Malay and English translations of the Short Form-Critical Thinking Disposition Inventory-Chinese Version (SF-CTDI-CV) and the Clinical Decision-making Nursing Scale (CDMNS) were used to collect data from 113 nurses working in seven critical care units of a tertiary hospital on the east coast of Malaysia. Participants were recruited through purposive sampling in October 2015.
RESULTS: Critical care nurses perceived both their critical thinking disposition and decision-making skills to be high, with a total score of 71.5 and a mean of 48.55 for the SF-CTDI-CV, and a total score of 161 and a mean of 119.77 for the CDMNS. One-way ANOVA test results showed that while age, gender, ethnicity, education level and working experience factors significantly impacted critical thinking (p<0.05), only age and working experience significantly impacted clinical decision-making (p<0.05). Pearson's correlation analysis showed a strong and positive relationship between critical care nurses' critical thinking and clinical decision-making (r=0.637, p=0.001).
CONCLUSION: While this small-scale study has shown a relationship exists between critical care nurses' critical thinking disposition and clinical decision-making in one hospital, further investigation using the same measurement tools is needed into this relationship in diverse clinical contexts and with greater numbers of participants. Critical care nurses' perceived high level of critical thinking and decision-making also needs further investigation.