Post-anesthetic recovery room registered nurses's experiences with technology assisted respiratory assessment during phase 1 recovery : an interpretive descriptive study
Bibliographic record
Abstract
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.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.013 | 0.028 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.004 | 0.004 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".