The impact of mandated use early warning system tools on the development of nurses' higher-order thinking: A systematic review

Tracy Flenady; Justine Connor; Amy-Louise Byrne; Deb Massey; Marie Danielle Le Lagadec

doi:10.1111/jocn.17178

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The impact of mandated use early warning system tools on the development of nurses' higher-order thinking: A systematic review

Journal article

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The impact of mandated use early warning system tools on the development of nurses' higher-order thinking: A systematic review

Tracy Flenady, Justine Connor, Amy-Louise Byrne, Deb Massey and Marie Danielle Le Lagadec

Journal of clinical nursing, Vol.33(9), pp.3381-3398

08/2024

DOI: https://doi.org/10.1111/jocn.17178

PMID: 38661093

Appears in Recent Faculty of Health Publications

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Abstract

higher‐order thinking

clinical reasoning

systematic review

nurses

early warning systems

Aim Ascertain the impact of mandated use of early warning systems (EWSs) on the development of registered nurses' higher-order thinking. Design A systematic literature review was conducted, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and checklist (Page et al., 2021). Data Sources CINAHL, Medline, Embase, PyscInfo. Review Methods Eligible articles were quality appraised using the MMAT tool. Data extraction was conducted independently by four reviewers. Three investigators thematically analysed the data. Results Our review found that EWSs can support or suppress the development of nurses' higher-order thinking. EWS supports the development of higher-order thinking in two ways; by confirming nurses' subjective clinical assessment of patients and/or by providing a rationale for the escalation of care. Of note, more experienced nurses expressed their view that junior nurses are inhibited from developing effective higher-order thinking due to reliance on the tool. Conclusion EWSs facilitate early identification of clinical deterioration in hospitalised patients. The impact of EWSs on the development of nurses' higher-order thinking is under-explored. We found that EWSs can support and suppress nurses' higher-order thinking. EWS as a supportive factor reinforces the development of nurses' heuristics, the mental shortcuts experienced clinicians call on when interpreting their subjective clinical assessment of patients. Conversely, EWS as a suppressive factor inhibits the development of nurses' higher-order thinking and heuristics, restricting the development of muscle memory regarding similar presentations they may encounter in the future. Clinicians' ability to refine and expand on their catalogue of heuristics is important as it endorses the future provision of safe and effective care for patients who present with similar physiological signs and symptoms. Impact This research impacts health services and education providers as EWS and nurses' development of higher-order thinking skills are essential aspects of delivering safe, quality care. No Patient or Public Contribution This is a systematic review, and therefore, comprises no contribution from patients or the public.

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Title: The impact of mandated use early warning system tools on the development of nurses' higher-order thinking: A systematic review
Creators: Tracy Flenady - Central Queensland University
Justine Connor - Central Queensland University
Amy-Louise Byrne - Central Queensland University, Rockhampton, Queensland, Australia
Deb Massey - Edith Cowan University
Marie Danielle Le Lagadec - Central Queensland University
Publication Details: Journal of clinical nursing, Vol.33(9), pp.3381-3398
Publisher: Wiley-Blackwell Publishing Ltd.
Grant note: RSH6503 / Central Queensland University
Identifiers: 991013181294902368
Copyright: © 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License Open access publishing facilitated by Central Queensland University, as part of the Wiley - Central Queensland University agreement via the Council of Australian University Librarians.
Academic Unit: Nursing; Faculty of Health
Language: English
Resource Type: Journal article

The impact of mandated use early warning system tools on the development of nurses' higher-order thinking: A systematic review

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