• J Adv Nurs · Feb 2016

    Comparative Study

    Chasing the Mirage: a grounded theory of the clinical reasoning processes that Registered Nurses use to recognize delirium.

    • Mohamed El Hussein and Sandra Hirst.
    • Faculty of Health & Community Studies, School of Nursing, Mount Royal University, Calgary, Alberta, Canada.
    • J Adv Nurs. 2016 Feb 1; 72 (2): 373-81.

    AimThe aim of this study was to construct a grounded theory that explains the clinical reasoning processes that registered nurses use to recognize delirium in older adults in acute care hospitals.BackgroundDelirium is under-recognized in acute hospital settings, this may stem from underdeveloped clinical reasoning processes. Little is known about registered nurses' (RNs) clinical reasoning processes in complex situations such as delirium recognition.DesignA grounded theory approach was used to analyse interview data about the clinical reasoning processes of RNs in acute hospital settings.MethodSeventeen RNs were recruited. Concurrent data collection and comparative analysis and theoretical sampling were conducted in 2013-2014.FindingsThe core category to emerge from the data was 'chasing the mirage', which describes RNs' clinical reasoning processes to recognize delirium during their interaction with older adults.ConclusionUnderstanding the reasoning that contributes to delirium under-recognition provides a strategy by which, this problem can be brought to the forefront of RNs' awareness and intervention. Delirium recognition will contribute to quality care for older adults.© 2015 John Wiley & Sons Ltd.

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