Autor(es): Cunha, Lara Daniela Matos ; Santos, Márcia Noélia Pestana dos ; Lomba, Maria de Lurdes Lopes de Freitas ; Santos, Margarida Reis
Data: 2023
Origem: Repositório Científico da Escola Superior de Enfermagem de Coimbra
Assunto(s): Clinical Reasoning; Nursing Realities; Uncertainty
Introduction or background Although it is widely acknowledged that the capacity to deal with uncertainty in given nursing clinical realities is an essential aspect of the provision of safe healthcare, there is little evidence on how to increase the ability to respond to uncertainty in nurses' clinical reasoning. Aim of the study The aims of this study are: 1) to describe the approaches that post-anesthesia nurses use to handle uncertainty in clinical reasoning; and 2) to map these approaches within the framework of the Integrative Framework for the Management of Uncertainty and the clinical realities of Wiedenbach's Prescriptive Theory. Methods/Design A descriptive qualitative study was undertaken. Fourteen nurses from a post-anesthesia care unit in a central Portugal hospital were recruited using a sampling method of convenience. Data was collected through semi-structured interviews and analyzed by thematic analysis. Results The central issue 'Uncertainty handling approaches in the clinical reasoning of nurses in Post-Anesthesia Care Units' included four themes: ignorance-centered, uncertainty-centered, response-centered and person-centered approaches. They were also charted for key realities of nursing care: recipient, skills, context, policies, objectives, techniques, procedures, devices, agent, time sequence, events and supportive relationships. Discussion and conclusions Post-anesthesia nurses use a variety of uncertainty handling approaches that can be usefully classified into a concrete framework. More research is needed to understand how the use of different approaches is influenced by various realities of nursing care and whether certain approaches can promote nurses' sense of wellbeing and enhance the safeness of nursing care. Practical and/or academic/research implications This research can offer healthcare workers and policy-makers invaluable insights, representing a departure for the development of organizational approaches that enable nursing staff to understand the orientation of their practices aimed at achieving safer post-operative care.
