The Characteristic of Nurses’ Eye Movements during Observation of Patients with Disturbed Consciousness

Nurses decide the patient’s problem and the priorities of care based on patients’ complaints and information obtained by observation when they care for patients. Nurses need to have insight during evaluation of patients with disturbed consciousness because they cannot complain about their pain and symptoms. The objective of this study was to clarify the characteristics of nurses’ eye movements during observation of patients with disturbed consciousness by comparing intuition ability, critical thinking, and clinical experience years. 

Participants were 19 nurses working on a neurosurgery ward in Japan and caring for patients with consciousness disturbance who were unable to speak. Ten novice nurses (24.8 ± 3.36 years old) and nine expert nurses (38.3 ± 5.77 years old) were compared. The observation scene, displayed on a computer screen, was a static image of a simulated patient in a resting state who had developed right putaminal hemorrhage. The authors showed the participants an information sheet about the simulated patient then used an eye tracking camera to analyze gaze points, gaze time, and gaze count during observation. The Kuroda Intrinsic Intuitive Ability Scale (KIIS) created by Kawahara and the Critical Thinking Disposition Scale created by Hirayama were used for measuring intrinsic intuition ability and critical thinking disposition. 

The results showed that there were no significant differences between observation time of novices (5.0 ± 2.01 minutes) and experts (5.4 ± 1.78 minutes), nor between their total gaze time and total count. The proportion of gazing at the monitor by novice nurses and gazing at the face and bed fences by expert nurses tended to be high. The KIIS general education score influenced the gaze time and gaze count during simulated patient observation. The KIIS logical thinking score affected the gaze count to the simulated patient’s face. 

In conclusion, there was no significant difference in total gaze time and count of novice and expert nurses. The nurses’ critical thinking ability influenced the count of gazing at the simulated patient’s face, and this suggests that observing the patient’s face may be related to nurses’ inferences.

Article by Ryoko Tsuchiya, et al, from Hirosaki University, Hirosaki, Japan.

Full access: http://mrw.so/32vQne

Image by Joana Cardoso, from Flickr-cc.