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Post-anesthetic recovery room registered nurses's experiences with technology assisted respiratory assessment during phase 1 recovery : an interpretive descriptive study

University of British Columbia

Background: Technology is prominent in the recovery room, but little is known about nurses’ use of technology in performing respiratory assessments, during the critical phase 1 recovery period. The purpose of this study was to investigate PACU nurses’ experiences of technology assisted respiratory assessment during phase 1 recovery. Methods: Interpretive Description was used to understand nurses’ experiences. Nine PACU nurses were recruited from three mid-sized hospitals within the same health authority, in a Western Canadian province. Nurse participants were interviewed using a semi-structured interview guide. Findings: Four themes were constructed from the data. Theme one described nurses’ confidence and trust in a visual sensory respiratory assessment process. Theme two described PACU nurses’ approach to technology. Theme three highlighted the contextual influences, which sustained the visual sensory approach to respiratory assessment. Theme four described PACU nurses’ descriptions of the technical challenges recognising deteriorating phase 1 recovery respiratory function. Discussion: PACU nurses practiced their intuitive sensory assessments with a projected strong sense of expert practice and minimal dependence on technology. However, a reliance on a sensory assessment and available technology did not always provide timely measures to detect abnormal respiratory function. PACU nurses expressed frustrations with current PACU technology and described some experiences with delayed identification of hypoventilation and hypoxia. Workplace cultural practices sustained PACU nurses’ respiratory assessment practices, the following factors have been highlighted in the literature to affect work place culture and patient outcomes; current and historical literature on perceptions of expert practice, implications of rationalized behaviors with technology use and alarm suppression, the influence of the wider culture of practice on practice performance, and the physiological challenges of assessing respiratory function on emergence from anesthesia. The case for and against more advanced respiratory monitoring technology is discussed. Marshall McLuhan’s tetrad of media effects tool was applied to the findings and found to have relevance and applicability in explaining the contextual elements in the data and bringing together the interpreted findings, under the umbrella of technological effects upon the PACU.

Text

2019-08-16

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/71317

Nursing

University of British Columbia

UBCO

http://creativecommons.org/licenses/by-nc-nd/4.0/