| Course | NR 351 Foundational Concepts for the Practicing RN |
|---|---|
| Week | 5 |
| Paper type | Concept analysis draft |
| Length | About 1,100 words, 5 pages |
| Format | APA 7 student paper |
| School | Chamberlain University |
| Program | RN-to-BSN |
| Updated | October 2026 |
Free sample paper for NR 351 Week 5
Situational Awareness in Nursing: A Concept Analysis With a Near Neighbor and One Case
Student Name
College of Nursing, Chamberlain University
NR 351: Foundational Concepts for the Practicing RN
Instructor Name
Month Day, Year
Situational Awareness in Nursing: A Concept Analysis With a Near Neighbor and One Case
Nurses are often praised for knowing what is going on, but that phrase hides a concept with a precise structure. Situational awareness began in aviation and military research and has since been adopted in nursing to describe how nurses perceive, understand and anticipate changes in patients and in the care environment. This draft analyzes the concept rather than describing it, following the general approach of identifying defining attributes, a contrasting concept and a model case described by Walker and Avant (2019). It defines situational awareness from the literature, sets out the attributes that must be present for the concept to apply, distinguishes it from nursing surveillance, a neighboring concept it is often confused with, and demonstrates it in one case from practice on an adult telemetry unit.
Definition and Defining Attributes
The most widely cited definition comes from Endsley (1995), who described situation awareness as the perception of elements in the environment within a volume of time and space, the comprehension of their meaning, and the projection of their status in the near future. In a concept analysis of situational awareness in nursing, Fore and Sculli (2013) adopted this structure and identified its attributes in nursing practice as perception, comprehension and projection, along with the recognition that awareness depends on the nurse's knowledge, experience and working conditions.
Three attributes, therefore, must all be present for the concept to apply. The first is perception: the nurse notices relevant cues, such as a change in heart rhythm, a patient's new restlessness or an alarm pattern. The second is comprehension: the nurse integrates those cues into a meaning, for example that restlessness plus a rising heart rate plus a falling oxygen saturation suggests deterioration rather than anxiety. The third is projection: the nurse anticipates what is likely to happen next and what will be needed, such as a rapid response call, oxygen escalation or a physician at the bedside. Perception without comprehension is noticing without understanding; comprehension without projection is understanding the present without preparing for the next hour. Only all three together make situational awareness.
A Near Neighbor: Nursing Surveillance
Situational awareness is often used interchangeably with nursing surveillance, and the boundary between them is where the concept becomes clear. Kelly and Vincent (2011) describe nursing surveillance as a purposeful, ongoing process of acquiring, interpreting and synthesizing patient data for clinical decision making, and they emphasize its systematic, patient-focused character: scheduled assessments, monitoring of trends and the nurse's responsibility to detect complications early.
The two concepts overlap in their attention to patient data and early recognition, but they differ in scope and in time. Surveillance is a nursing process directed at patients, carried out through planned and repeated assessment. Situational awareness is a cognitive state that covers the whole environment, including patients, equipment, staffing, other team members' workloads and competing demands, and it can change from minute to minute. A nurse can perform surveillance correctly, completing every scheduled assessment, and still lack situational awareness if she does not notice that the patient in the next room has pulled out an intravenous line while the monitor technician is on break. Conversely, situational awareness includes projection into the near future in a way that surveillance, as a process, does not require. Surveillance is something a nurse does; situational awareness is something a nurse has, or loses, while doing it.
Demonstration in One Case
A single case from the writer's practice shows the three attributes. On a night shift on a 30-bed telemetry unit, the writer was caring for five patients, one of whom, a man in his seventies admitted with pneumonia, had been stable all evening. At 0300 the writer noticed three things within ten minutes: the monitor showed his heart rate rising from the 80s into the 110s, his oxygen saturation had drifted from 95 percent to 91 percent on the same flow rate, and when the writer entered the room he was picking at his blanket and did not know what day it was. That was perception.
The writer put the cues together: a rising heart rate, falling saturation and new confusion in an older adult with pneumonia pointed toward worsening infection, possible sepsis or hypoxia, rather than a patient who was simply awake and anxious. That was comprehension. The writer then anticipated what would happen next if nothing changed: further desaturation, possible hypotension and a need for a higher level of care. She increased oxygen as ordered, obtained a full set of vital signs including temperature and blood pressure, told the charge nurse she would likely need help in the next hour, and called the rapid response team before the patient's blood pressure fell. That was projection. The patient was transferred to the progressive care unit and treated for sepsis.
The case also shows the environmental side of situational awareness that separates it from surveillance. Before calling the rapid response team, the writer checked that her other four patients were stable and asked the charge nurse to watch one who was due for a potassium replacement, anticipating that she would be in one room for a long time.
Why the Concept Matters to Practice
Situational awareness matters because many failures to rescue deteriorating patients are failures of one of its three attributes rather than failures of knowledge. Cues are missed because a nurse is overloaded, understood too late because they arrive one at a time, or not projected because the nurse is focused on completing tasks. Fore and Sculli (2013) note that workload, interruptions and fatigue all reduce situational awareness, which suggests that the concept depends as much on the conditions of work as on the individual nurse. Naming the three attributes gives nurses a language for teaching new colleagues and for debriefing events: whether the cues were perceived, whether they were understood and whether anyone anticipated what came next.
The concept also has limits worth stating. Because situational awareness is a cognitive state, it cannot be observed directly, only inferred from what a nurse noticed and did, and it is easiest to judge in hindsight, after an outcome is known. A draft that treats every bad outcome as a lapse in awareness would misuse the concept, since some deteriorations give no cues until late. The honest use of the concept is prospective: asking what a nurse could have perceived at the time.
References
Endsley, M. R. (1995). Toward a theory of situation awareness in dynamic systems. Human Factors, 37(1), 32-64. https://doi.org/10.1518/001872095779049543
Fore, A. M., & Sculli, G. L. (2013). A concept analysis of situational awareness in nursing. Journal of Advanced Nursing, 69(12), 2613-2621. https://doi.org/10.1111/jan.12130
Kelly, L., & Vincent, D. (2011). The dimensions of nursing surveillance: A concept analysis. Journal of Advanced Nursing, 67(3), 652-661. https://doi.org/10.1111/j.1365-2648.2010.05525.x
Walker, L. O., & Avant, K. C. (2019). Strategies for theory construction in nursing (6th ed.). Pearson.
What the NR 351 Week 5 assignment asks for
The Week 5 assignment asks you to develop a concept analysis of the professional concept you have been working on. Course materials usually specify a definition from scholarly sources, defining attributes, a comparison that clarifies the concept, a case that illustrates it, its significance to nursing and APA format, often following Walker and Avant's method. Take the definition from the original theorist and a nursing analysis. List the attributes as a set and explain what is missing if one is absent. Choose a near neighbor that is often confused with your concept and show the boundary. Develop one case in enough detail to show each attribute. State the concept's limits as well as its value.
How the NR 351 Week 5 example is put together
The introduction notes that "knowing what is going on" hides a precise structure. The definition section uses Endsley's three levels and Fore and Sculli's application to nursing, then presents perception, comprehension and projection as attributes that must all appear. The near neighbor section uses Kelly and Vincent's analysis of surveillance and explains that surveillance is a planned process directed at patients, while situational awareness is a state that includes the environment. The case follows a night on a 30-bed telemetry unit: a man with pneumonia whose rising heart rate, falling saturation and new confusion were noticed, combined and projected forward, and a nurse who checked her other patients before calling. The last section links the concept to failure to rescue and states that it is judged mostly in hindsight.
Where the points sit in the NR 351 Week 5 rubric
Concept analysis rubrics usually score the definition and sources, the defining attributes, the use of a contrasting or related concept, the illustrative case, significance to nursing, organization and APA. Defining attributes and the contrast together carry the most points, because they show the concept being analyzed rather than praised. This draft lists the three attributes and explains what is lost without each. The near neighbor earns credit because surveillance is defined from its own source and the difference is made concrete. The case row is met by one detailed night shift in which each attribute can be traced. Significance scores through the link to failure to rescue, and stating limits shows critical thinking. Walker and Avant frame the method.
NR 351 Week 5 help from the desk
The predictable loss on this draft is description in place of analysis, where the concept is praised and its importance affirmed but nothing is taken apart. The second is the missing contrast, a concept defined accurately and never set beside the idea it is most often confused with. Students also use several thin examples instead of one developed case, or let the case run without pointing to each attribute. Changing the concept at this point is usually a mistake, since earlier papers built toward it. Patient details must be removed from the case. Four to six scholarly sources are typical for a draft. If your concept is different, tell us and an NR 351 concept analysis can be outlined with a near neighbor that fits it.
Get a NR 351 Week 5 example written to your instructions
Send the Week 5 instructions, your outline and the sources you gathered, and a custom example is drafted to your own structure and returned inside 24 to 48 hours. The first one is free. The practice situation you use remains yours to supply and to describe.
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NR 351 Week 5 questions, answered
What is the difference between analysis and description here?
Description says what a concept is and why it is good. Analysis says what has to be true for the concept to apply, what it is not, and what it looks like in a case. The clearest test is whether the paper contains a sentence distinguishing the concept from something close to it, because description never needs one.
How many sources does the draft need?
The number your section sets, usually placed where the concept is defined and bounded. Sources are not required for the parts describing your own practice. Clustering them in the introduction and leaving the definitional section uncited is the pattern instructors notice, since it is the definitional work that actually rests on the literature.
Can I change my concept at this stage?
Ask your instructor first, because most sections tie the draft to the concept approved earlier. Where a change is allowed it usually means redoing the annotated bibliography as well, since the sources were chosen for the original concept. Narrowing the same concept is nearly always easier and is often what the difficulty actually calls for.
Where can I find a free NR 351 Week 5 sample paper?
The full Week 5 concept analysis of situational awareness, with Endsley's definition, the three attributes, the surveillance contrast, the telemetry case and four references, is on this page.
How does the NR 351 Week 5 paper separate situational awareness from surveillance?
Surveillance is a planned, repeated nursing process directed at patients, while situational awareness is a mental state that also takes in the environment, such as checking other patients before leaving to respond.