Integrative Literature Review on Cognitive Science to Reconsider Failure to Rescue in Nursing: A Call to Action

Abstract

Background: When current workload demands exceed the cognitive capacity of nurses, tasks that are critical to early detection of clinical deterioration may be omitted. In many high-risk industries that require vigilance over sustained periods, such as the military, the cognitive resource theory of vigilance heavily guides systematic approaches. Yet, in research and policy on nursing failure to rescue, that same application of a cognitive science framework has been overlooked. Method: The nursing literature on failure to rescue was reviewed through the lens of the cognitive resource theory of vigilance. Fifteen articles met the inclusion criteria. Results: Four themes emerged: relationship between clinical judgment and failure to rescue, implicit reference to the cognitive resource theory of vigilance, benefits of simulation-based education, and caregiver fatigue. Conclusion: The use of cognitive science to target advancement of patient management strategies has the potential to lead to a decrease in failure to rescue and an increase in nursing cognitive task efficiency. [ J Contin Educ Nurs. 2023;54(6):253–260.]