Nurse-Client Situated Interaction (NCSI): A Constructivist Grounded Theory of the Indicators and Clinical Reasoning Processes that Registered Nurses Use to Recognize Delirium in Older Adults in Acute Care Settings
Date
2015-01-12
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Abstract
Delirium is an acute disorder of attention and cognition in older adults. It affects half of the older adults admitted to acute care settings and is a major cause of increasing mortality and healthcare costs. Delirium is preventable in 30–40% of cases and its early recognition is crucial to improve prognosis. Registered Nurses’ (RNs) prolonged interactions with older adults place them in an advantageous position to recognize delirium. Regrettably, RNs often fail to recognize delirium in older adults. The goal of this research was to identify the indicators and clinical reasoning processes that RNs use to recognize delirium in older adults in acute care settings. Purposive and theoretical sampling techniques were used to recruit 17 RNs for this study. Data gathering and analysis from participants’ interviews was done concurrently using Constructivist Grounded Theory. The logic of constant comparison and memo-writing facilitated the transitioning from initial to focused coding. Coding for processes culminated in the emergence of the Nurse-Client Situated Interaction (NCSI) as the core category of the substantive grounded theory. NCSI refers to the main strategies that RNs used to resolve concerns of delirium recognition in older adults in acute care settings. NCSI consists of 3 subcategories that emerged from data. Each subcategory is rooted in several properties that were derived directly from the rich descriptions provided by the participants in the interviews. The subcategories and their respective properties in relation to the current state of the science are discussed in this thesis. Discussions of the recommendations that are relevant to the practices of RNs are included. Finally, limitations of the study and the agenda for future research (concatenation) are discussed.
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Nursing
Citation
EL HUSSEIN, MOHAMED. (2015). Nurse-Client Situated Interaction (NCSI): A Constructivist Grounded Theory of the Indicators and Clinical Reasoning Processes that Registered Nurses Use to Recognize Delirium in Older Adults in Acute Care Settings (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/27147