Nurses Decision Making Process in Peritoneal Dialysis

Abstract

Purpose Chronic kidney disease is now considered a major public health problem. Over the past two decades, the number of patients that started dialysis is more than doubled. Patient Management in Peritoneal Dialysis (PD) is considered as an advanced skill that requires technical technical competences, prevention and management of complications, as well as communicative-relational and educational knowledge to address patients and the caregiver needs. In clinical settings, patient management in PD is entrusted to the experienced professional who becomes the central resource for the patient and for the interior care team. In one type of such specialist care, it is important to understand what are the thought processes that guide the nurse expert decisions, so that the novice nurses through this explanation can learn about similar thought processes and enhance their expertise. The study describes the different processes of thought, between expert and novice nurses, that guide the decision making in the management of patients in PD. Methods Quali-quantitative study, with simulated clinical cases. Results Experts gather complex data, focusing the relevant ones and possess perceptual acuity and effective observation skills. They make assumptions about possible problems, anticipate the presence and act with proactive mode. The novices collect a lot of data, less relevant, and monitor many parameters that do not know how to interpret. They make reference to general notions that do not correlate with the problem, find it difficult to set priorities and act in a reactive mode. Conclusions The study confirms the results of previous studies, however made in different clinical settings. The results obtained can be used for training courses for novice nurses for patient's management in PD, using the expertise of the expertise of competent professionals. (nursing)