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Title: Children in intensive care : nurses perceptions of need.
Author: Endacott, Ruth.
ISNI:       0000 0001 3447 9396
Awarding Body: University of Exeter
Current Institution: University of Exeter
Date of Award: 1998
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This study investigates the manner in which intensive care nurses perceive, and take action to meet, the needs of the critically ill child, with the aim of answering three research questions: 1. What care is provided for the critically ill child in the intensive care unit? 2. How do nurses identify and act on the needs of the critically ill child? 3. What dimensionso f knowing underpint he way in which nursesp erceivea nd act on the needs of the critically ill child? A modified Delphi technique was used to provide an expert opinion on the needs of the critically ill child. A case study approach, informed by ethnographic principles, was used to structure observationsa nd interviewsi n one paediatrici ntensivec are unit (ICU) and two general ICUs. Carper's (1978) four dimensions of knowing (aesthetic, ethical, empiricala nd personakl nowing) underpinnedc ases tudy data collectiona nd analysis. The study findings expanded Carper's original work by identifying an additional dimension of knowing, referred to as contextual knowing, which nurses used to relate empirical and aesthetic knowledge to the individual child. This influenced their perception of whether a changed situation constituted a need. The five dimensions of knowing were used in an inter-related way by the nurses; no hierarchy was evident as priority was given to the dimension most relevant in a given situation. The findings highlight the key role of the nurse at the bedside (the allocated nurse) in identifying, legitimising and acting on the needs of the child. The importance of experience and confidence in enabling the nurses to undertake activities such as gate-keeping andprioritising in order to meett he needso f the child was also emphasisedT. he shift leader supported the nurses and co-ordinated the overall activity on the Unit. There was no overall difference in the role adopted by families in the General and Paediatric ICUs. Nursing records were an historical record of care, rather than a plan of care, and did not detail decision-making and prioritising activity frequently observed in the intensive care units. Recommendations are made for strategies to retain experienced nursing staff at the bedside, the active promotion of learning through experience, incorporating prioritising of care in records and a more inclusive framework for measuring and costing nursing workload in ICU
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Nursing