Cue utilization by expert pediatric critical care nurses in making clinical judgments related to endotracheal suctioning.

Abstract

The nature of nursing judgment in clinical practice situations remains incompletely explored. It is known that nurses perform endotracheal suctioning as part of the nursing care of critically ill children. However, the ways in which nurses judge the need for suctioning and the method used to suction are not well understood. This research study was conducted to describe the cues that expert pediatric critical care nurses use in making the judgment to suction and to describe how those cues are used in determining the timing of endotracheal suctioning. A qualitative naturalistic study was conducted in a quaternary pediatric critical care unit in Central Canada. A purposive sample of seven expert pediatric critical care nurses participated in the study. Data were collected using three methods---participant observations (field notes), think aloud (concurrent verbalizations) and semi-structured interviews (retrospective verbalizations)---as participants cared for ventilated, critically ill children. (Abstract shortened by UMI.)