Predictive Strategies in Diagnostic Tasks

Gordon, Marjory

doi:10.1097/00006199-198001000-00030

Cited by 58 publications

(37 citation statements)

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“…Situational Context Gordon, 1980 Time constraints When information was deliberately restricted to no more than 12 units of info, subjects were more accurate (88%) than with unlimited information (48%; p =.001). Cianfrani, 1984 Increased time to diagnose was associated with lower accuracy.…”

Section: Categories and Researchers Factors Signifi Cant Findingsmentioning

confidence: 99%

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Standardized Nursing Languages Essential for the Nursing Workforce

Jones¹,

Lunney²,

Keenan³

et al. 2010

Annu Rev Nurs Res

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The evolution of standardized nursing languages (SNLs) has been occurring for more than four decades. The importance of this work continues to be acknowledged as an effective strategy to delineate professional nursing practice. In today's health care environment, the demand to deliver cost-effective, safe, quality patient care is an essential mandate embedded in all health reform policies. Communicating the contributions of professional nursing practice to other nurses, health providers, and other members of the health care team requires the articulation of nursing's focus of concern and responses to these concerns to improve patient outcomes. The visibility of the electronic health record (EHR) in practice settings has accelerated the need for nursing to communicate its practice within the structure of the electronic format. The integration of SNLs into the patient record offers nurses an opportunity to describe the focus of their practice through the identification of nursing diagnosis, interventions and outcomes (IOM, 2010). Continued development, testing, and refinement of SNLs offers nursing an accurate and reliable way to use data elements across populations and settings to communicate nursing practice, enable nursing administrators and leaders in health care to delineate needed resources, cost out nursing care with greater precision, and design new models of care that reflect nurse-patient ratios and patient acuity that are data driven (Pesut & Herman, 1998). The continued use of nursing languages and acceleration of nursing research using this data can provide the needed evidence to help link nursing knowledge to evidence-driven, cost-effective, quality outcomes that more accurately reflect nursing's impact on patient care as well as the health care system of which they are a part. The evaluation of research to support the development, use, and continued refinement of nursing language is critical to research and the transformation of patient care by nurses on a global level.

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Section: Categories and Researchers Factors Signifi Cant Findingsmentioning

confidence: 99%

“…Factors Signifi cant Findings Gordon, 1980 Task complexity Subjects did better when information was limited (see above); unlimited amount of data was assoc with continuation of predictive hypothesis testing. Cianfrani, 1984 Amount of data With high amounts of data, accuracy decreased with 1 of the 3 CS (p = .001).…”

Section: Categories and Researchersmentioning

confidence: 99%

Standardized Nursing Languages Essential for the Nursing Workforce

Jones¹,

Lunney²,

Keenan³

et al. 2010

Annu Rev Nurs Res

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“…• successful clinical decision-making is based upon a hypothetico-deductive process involving inductive and deductive reasoning skills (Gordon, 1980;Putzier, Padrick, Westfall and Tanner, 1985;Padrick, Tanner, Putzier and Westfall, 1987;Ellis, 1997);…”

Section: The Prototype Clinical Decision Simulatormentioning

confidence: 99%

Designing intelligent computer-based simulations: A pragmatic approach

Garrett

Callear

2001

ALT-J

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This paper examines the design of intelligent multimedia simulations. A case study is presented which uses an approach based in part on intelligent tutoring system design to integrate formative assessment into the learning of clinical decision-making skills for nursing students. The approach advocated uses a modular design with an integrated intelligent agent within a multimedia simulation. The application was created using an object-orientated programming language for the multimedia interface (Delphi) and a logic-based interpreted language (Prolog) to create an expert assessment system.Domain knowledge is also encoded in a Windows help file reducing some of the complexity of the expert system. This approach offers a method for simplifying the production of an intelligent simulation system. The problems developing intelligent tutoring systems are examined and an argument is made for a practical approach to developing intelligent multimedia simulation systems.

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“…They may reflect socialization into nursing models, familiarity with particular disease patterns, past experience with like patients, or cultural influences. In her model of diagnosing, Gordon (1980) makes explicit room for the use of variables such as patients' housing, age, or type of surgery in eliminating hypotheses. Price (1987) reports that the predictability of a patient's hospital course as well as sex and age influence the assessment of patients.…”

Section: Individual Factorsmentioning

confidence: 99%

The Impact of Individual and Contextual Factors on Nursing Care and the Implementation of AHCPR Practice Guidelines

Arndt¹,

Bigelow²

1994

Medical Care Review

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Clinical practice guidelines are meant to assist practitioners in making decisions about appropriate care (Field and Lohr 1992). They are also an attempt to exercise control over practice variation and, by eliminating ineffective services, to reduce the cost of health care (Garber and Wagner 1991). The concept of practice guidelines has received renewed attention with the establishment of the Agency for Health Care Policy and Research (AHCPR) whose guidelines cross disciplinary lines and are expected to affect nursing care as well as medical care (Jacox, Ferrell, Heidrich, et al. 1992). Although nursing is the largest single component of inpatient cost (McKibbin et al. 1985; U.S. Department of Health and Human Services 1987; Walker 1983) and, like medical care, is subject to practice variation (Hinshaw, Verran, and Chance 1977; Fetter, Thompson, Ryan, et al. 1987; Skydell and Arndt 1988), research and policy discussions traditionally focus on the effect of guidelines on medical practice. Downloaded from 62 analyzing the potential impact on nursing care of the guidelines proposed by the AHCPR.An underlying assumption of practice guidelines is that clinical practice can be altered by rational information about outcomes and patient preferences (Eddy 1988). However, it has been pointed out that the link between information and actual medical or nursing care may be moderated by other factors (Waitzken and Hubbell 1992;Coyle and Sokop 1990;Kirchhoff 1982). This article looks at such influences on nursing care, arguing that nursing care not only is a function of the patient's illness but is influenced as well by the nurse's cognition and by the organizational context.The health management literature has paid little attention to the effect of individual or contextual factors on nursing care. The nursing literature adds insights but is not consistent in the factors it admits as influences. For example, theoretical models of nursing, which are concerned with what nursing &dquo;ought to be&dquo; (Stevens 1984), sometimes acknowledge that nurses' perceptions play a role in patient assessment (King 1981;Neuman 1982;Orem 1985) but discount influences from the work setting (Orem 1985;Orlando 1961). Practitioner literature, on the other hand, often recognizes the work setting as an important influence on nursing care (Aydelotte 1972;Hodges, Sanford, and Elzinga 1986;Van Slyck 1987), yet discounts nurses' perceptions, describing patient assessment as an objective analysis of patient need (Aydelotte 1972;Halloran 1988; Yura and Walsh 1988). The intent of this article is first to review the research on the impact of individual and contextual factors on nursing care, and second to analyze their impact on the implementation of AHCPR practice guidelines.The article is organized into three sections. The first draws on diverse fields, including nursing, psychology, sociology, health policy, and management, to describe individual and organizational factors that affect decisions about nursing care. The second section turns to an analysis ...

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Predictive Strategies in Diagnostic Tasks

Cited by 58 publications

References 0 publications

Standardized Nursing Languages Essential for the Nursing Workforce

Standardized Nursing Languages Essential for the Nursing Workforce

Designing intelligent computer-based simulations: A pragmatic approach

The Impact of Individual and Contextual Factors on Nursing Care and the Implementation of AHCPR Practice Guidelines

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