Clinical credibility and trustworthiness are key characteristics used to identify colleagues from whom to seek information

Abstract

Aims and objectives To explore the use of information by nurses making decisions in clinically uncertain situations in one aspect of critical care nursing practice (enteral feeding). In this paper, we report the characteristics, which participants identified as important, of the people from whom they sought information for the purpose of making clinical decisions. Background Registered nurses have a plethora of information sources available to assist them in making clinical decisions. Identifying and selecting the best information to support these decisions can be difficult and is influenced by factors such as accessibility, usefulness and variations in quality of the information. Design An instrumental case study design using multiple case study analysis. Method Twenty‐two critical care nurses from two intensive care units contributed to the data through multiple methods of data collection including concurrent verbal protocols (think aloud), retrospective probing and focus group interviews. Results Nurses preferentially used colleagues as a source of information when faced with uncertainty about their clinical practice. Most participants placed greater emphasis on evaluating the individual providing the information rather than on evaluating the information itself. Key features used for identifying an individual as a source of information included experience, clinical role, trust and approachability. Conclusion Establishing clearly what clinical credibility means, and to what extent trustworthiness and expertise play a role in the establishment of credibility, is an important debate for nursing. We need to carefully consider what defines the construct of clinical credibility and how this aligns with the concept of clinical currency, to allow clinicians to determine in others the characteristics associated with clinical credibility to access quality information through social interaction. Relevance to clinical practice Processes to focus on determining the quality of information obtained from colleagues should be emphasised. What these processes are and how they could be implemented into clinical practice remains unknown and is highlighted as an area for future research.

An Integrative Literature Review of the Factors That Contribute to Professional Nurses and Midwives Making Sound Clinical Decisions

“…The factors that were most strongly influential were the physical and clinical status of the patient and the experience of the nurse or midwife. Factors were identified in a variety of settings, including obstetric units (Cheyne et al., ; Oduro‐Mensah et al., ; Wu et al., ), intensive care units (Aitken, Marshall, Elliott, & McKinley, ; Marshall et al., ; Tai, ), acute or critical care units (Bucknall, ; Cioffi, Conwyt, Everist, Scott, & Senior, ; Currey & Worrall‐Carter, ; Currey, Browne, & Botti, ; Hancock & Easen, ; Hirsh et al., ; Hoffman, Donoghue, & Duffield, ; Lavellea & Dowling, ; McNett, Doheny, Sedlak, & Ludwick, ; Rattray et al., ; Thompson et al., ), coronary care units (Bakalisa et al., ; Currey & Botti, ), emergency departments (Chung, ; Garbez, Carrieri‐Kohlman, Stotts, Chan, & Neighbor, ; Gerdtz & Bucknall, , ), psychiatric units (Dewar, Mullett, & Langdeau, ; Lindsey, ), medical/surgical wards (Harper, Ersser, & Gobbi, ; Hasegawa, Ogasawara, & Katz, ; Helmrich et al., ; King & Macleod, ; Ludwick et al., ; Pantazopoulos et al., ), and palliative and oncology wards (Searle & McInerney, ).…”

No Need to Object: Ethical Obligations for Interprofessional Collaboration in Emergency Department Discharge Planning

“…Not identifying someone as trustworthy when he or she acts outside of the role means valuable information is lost. By contrast, uncritically accepting recommendations based on established trustworthiness of a colleague risks overvaluing possible faulty information (Marshall, West, & Aitken, 2013). Whether a clinician is identified as trustworthy or not does not change the obligation of clinicians to value and assess all information presented to them (Dhaliwal, 2011;Marshall et al, 2013).…”

“…Recognizing trustworthiness in another person requires a strong correlating relationship (McLeod, 2014). The development of relationships over time is not always possible in the clinical setting, and often there is a member of the healthcare team who is new to the unit or floor.…”

“…Incorrect patient disposition jeopardizes their safety and is linked to increased patient mortality and avoidable adverse events (Metcalfe, Sloggett, & McPherson, 1997;Trinkle & Flabouris, 2011;Vlayen et al, 2012). A noninclusive disposition process limits a clinician' s ability to practice virtues and thus risks the virtues themselves.…”

Life as a Mentor

“…Together, they plan and implement problem-solving strategies in a milieu of sharing that overcomes defensive postures and promotes openness to each other's suggestions (Marshall, West, & Aitken, 2013;Vance & Olson, 1998). Mentor-colleagues act as collaborators or consultants to young or established scholars.…”