title: Clinical judgments about endotracheal suctioning: what cues do expert pediatric critical care nurses consider?
abstract: Making accurate and timely judgments based on multiple ways of knowing is an essential skill in critical care nursing practice. Studies have proposed that positive patient outcomes are linked to expert judgments in a variety of critical care situations; however, little is known about clinical judgments related to specific critical care nursing interventions. This article presents a qualitative nursing research study which examined the cues that expert pediatric critical care nurses used in making clinical judgments about suctioning intubated and ventilated, critically ill children. The participants' words and actions attest that the 'sensing' and 'thinking' of the process of cue use, are interwoven with, and integral to, the 'doing,' which is the process of skilled performance.
authors.affiliation: Pediatric Intensive Care Unit, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario K1H 8L1, Canada. thomas@cheo.on.ca
authors.forename: Margot
authors.initials: M
authors.lastname: Thomas
authors.forename: Frances
authors.initials: F
authors.lastname: Fothergill-Bourbonnais
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D002648:Child; D002983:Clinical Competence; D003422:Critical Care / Q000379:methods*; D003463:Cues; D004417:Dyspnea / Q000175:diagnosis / Q000209:etiology / Q000451:nursing; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007442:Intubation, Intratracheal / Q000451:nursing; D007600:Judgment; D009730:Nursing Assessment / Q000379:methods*; D015404:Nursing Methodology Research; D009736:Nursing Process; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology; D046709:Pattern Recognition, Physiological; D010371:Pediatric Nursing / Q000379:methods*; D011597:Psychomotor Performance; D036301:Qualitative Research; D012121:Respiration, Artificial / Q000451:nursing; D013396:Suction / Q000451:nursing*; D011795:Surveys and Questionnaires; D013850:Thinking