What is the lived experience of Advanced Nurse Practitioners of managing risk and patient safety in acute settings? A phenomenological perspective

Girdher, Juliet Louise

Abstract

Background: Managing clinical risk and patient safety is high on clinical and political agendas. Advanced Nurse Practitioners (ANPs) are frontline practitioners making critical decisions regarding risk and patient safety. Whilst research around nurse decision-making has been conducted, the extent to which ANPs manage and navigate patient safety and risk is under-researched.

Research question: What is the lived experience of Advanced Nurse Practitioners of managing risk and patient safety in acute settings? A phenomenological perspective.

Method: Ten ANPs across three acute settings were recruited and iterative data collected over ten months on experiences of managing risk and safety (reflective interviews, written reflections, researcher journal). Data analysis was based on Van Manen’s approach, assisted by NVivo 11 to facilitate circles of interpretation with each data source.

Findings: In an environment driven by time pressures, how practitioners cope with managing risk and patient safety is dependent on the presenting situation, breadth of knowledge-base, application of evidence, degree of perceived management support, and channelling of emotive moods. In situations of uncertainty, insufficient knowledge, and/or lack of information, practitioners were guided by care, concern, worry, feeling happy or comfortable and, in critical times, fuelled by fear. These were illuminated to be both drivers and barriers to practitioners’ capabilities in grasping patient presentations. Snapshot judgements were individualized and negotiated dependent on practitioners’ and patients’ capacity to cope with risk. Experiences of risk often identified a learning need or knowledge deficit, revealing an opportunity to develop and advance ANP practice.

Implications: These findings have implications for the preparation, training, and ongoing educational and emotional support of ANPs within their practice. Recognising the emotional toll of managing risk and providing the necessary support will ultimately positively impact recruitment and retention of these crucial health care professionals.

Citation

Girdher, J. L. What is the lived experience of Advanced Nurse Practitioners of managing risk and patient safety in acute settings? A phenomenological perspective. (Thesis). University of the West of England. Retrieved from https://uwe-repository.worktribe.com/output/1491308

• Thesis Type: Thesis
• Publicly Available Date: Aug 5, 2019
• Public URL: https://uwe-repository.worktribe.com/output/1491308
• Award Date: Aug 5, 2019