Information sources used in decision making: considerations for simulation development

113

This paper is concerned with the conceptual frameworks which could be applied to nurse practitioners in general practice in reaching decisions during patient consultations. Four strategies of decision making are explained within a practice context: hypothetico-deductive method, decision analysis, pattern recognition and intuition. The study uses retrospective verbalization and observation of 20 nurse practitioners working alongside general practitioners to explore decision making issues. The results of the study show that important factors relating to decision making include: the ability to recognize patterns in clinical situations to fit with patterns previously seen; an appreciation of the consequences of inappropriate action; and the ability to concentrate simultaneously on complex and sometimes masked patient cues as well as multiple treatment options.

Section: Aim Of the Studymentioning

confidence: 63%

The application of decision making concepts by nurse practitioners in general practice

Offredy

1998

113

“…They argued that the difference between research‐based and practice‐based knowledge was an ‘illusion’, the former having diffused so thoroughly into professional culture that it had become ‘owned’ by practitioners. The pragmatic approach to the study of decision‐making has underpinned a number of studies ( Luker & Kenrick 1995, Kenrick & Luker 1996, Lamond et al . 1996 , Chalmers et al .…”

Section: Literature Reviewmentioning

confidence: 99%

Wound care in the community setting: clinical decision making in context

Hallett

Austin

Caress

et al. 2000

Sixty-two community nurses in northern England of grades B and D to H were interviewed by a team of four researchers. The interviews were semi-structured, and were tape-recorded, fully transcribed and content analysed. They were conducted as part of a larger study, the aim of which was to examine community nurses' perceptions of quality in nursing care. One of the main themes the work focused on was decision-making as an element of quality. Data relating to wound care were considered from the perspective of the insights they offered into clinical decision-making. Data were interpreted in the light of a literature review in which a distinction had been made between theories which represented clinical decision-making as a linear or staged process and those which represented it as intuitive. Within the former category, three sub-categories were suggested: theorists could be divided into 'pragmatists', 'systematisers' and those who advocated 'diagnostic reasoning'. The interpretation of the data suggested that the clinical decisions made by community nurses in the area of wound care appeared largely intuitive, yet were also closely related to 'diagnostic reasoning'. They were furthermore based on a range of sources of information and justified by a number of different types of rationale.

“…1987 ) and intuition ( Benner & Tanner 1987). Some of this research suggests that the nursing shift report is an important source of information upon which judgements and decisions may be based ( Lamond et al . 1996 , Taylor 1997).…”

Section: Introductionmentioning

confidence: 99%

“…Information in this instance was defined as an item of knowledge about the patient, their family and their clinical environment ( Lamond et al . 1996 ).…”

Section: Introductionmentioning

confidence: 99%

The information content of the nurse change of shift report: a comparative study

Lamond

2000

Self Cite

The information content of the nurse change of shift report: a comparative study This study examines the role which the nursing change of shift report may have in aiding nurses to process information and plan care. It also aims to identify whether any of the information found in the shift report can be considered as 'forceful feature' information, the key features of a situation which allow an individual to access appropriate knowledge within their long-term memory store. The content of the medical notes, nursing documentation and shift reports for a total of 60 patients, selected from two acute medical and two acute surgical wards across two National Health Service Hospital Trusts in south-east England were subjected to content analysis. The types and amount of information contained in each source were examined, along with the order of information given in the shift reports. A multidimensional scalogram analysis (MSA) was also carried out on the data to examine the patterns of information content across sources. In general, more information was recorded in the patients' notes than communicated during the shift report. However, both the frequency data and the MSA plots indicated that particular types of information (identified here as global judgements) were often communicated in the shift report but not recorded in the patient notes. The results suggest that there is evidence that the change of shift report contains 'forceful feature' information. The presence of such 'forceful features' may facilitate the processing of patient information during the shift report communication, leading to more efficient care planning.