The decision making of heart failure specialist nurses in clinical practice

Dowding, Dawn; Spilsbury, Karen; Thompson, Carl; Brownlow, Ros; Pattenden, Jill

doi:10.1111/j.1365-2702.2008.02700.x

Cited by 28 publications

(60 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on the scoring system developed for the shortened instrument, results from the present study show that in the whole sample of nurses the “window” for perceived quasi-rational approaches in CDM is large. This is similar to nurses in Dowding et al's study [19] and with Hammond's [5] suggestion that it is most common to oscillate between analytical and intuitive modes of cognition during decision making. Also, the analytical-systematic model is perceived to be much more in use than the intuitive-interpretive model.…”

Section: Discussionsupporting

confidence: 86%

“…Since 1999, several authors have suggested that Hammond's CCT could be a possible alternative way of conceptualizing decision making in nursing [4, 16, 17]. In two qualitative studies, CCT was used either as an explicit analytical tool [18] or as a theoretical perspective in the framing and discussion of the study [19]. Both studies concerned nurses' decision making during pharmacological management.…”

Section: Introductionmentioning

confidence: 99%

“…Both studies concerned nurses' decision making during pharmacological management. Both studies also report a mismatch between the type of decision making nurses used and the characteristics of the situation, for example, that intuitive approaches were used when more analytic approaches should have been used [18], or that appropriate decision tools were missing to help nurses during their analytical approaches [19]. …”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Decision Making of Nurses Working in Hospital Settings

Bjørk

Hamilton²

2011

Nursing Research and Practice

View full text Add to dashboard Cite

This study analyzed nurses' perceptions of clinical decision making (CDM) in their clinical practice and compared differences in decision making related to nurse demographic and contextual variables. A cross-sectional survey was carried out with 2095 nurses in four hospitals in Norway. A 24-item Nursing Decision Making Instrument based on cognitive continuum theory was used to explore how nurses perceived their CDM when meeting an elective patient for the first time. Data were analyzed with descriptive frequencies, t-tests, Chi-Square test, and linear regression. Nurses' decision making was categorized into analytic-systematic, intuitive-interpretive, and quasi-rational models of CDM. Most nurses reported the use of quasi-rational models during CDM thereby supporting the tenet that cognition most often includes properties of both analysis and intuition. Increased use of intuitive-interpretive models of CDM was associated with years in present job, further education, male gender, higher age, and working in predominantly surgical units.

show abstract

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Decision Making of Nurses Working in Hospital Settings

Bjørk

Hamilton²

2011

Nursing Research and Practice

View full text Add to dashboard Cite

show abstract

“…This is especially evident in regard to medication interactions and the trading of risks and benefits during titration to achieve therapeutic responses while preventing unwanted complications and adverse effects. 50 Advanced practice nurses (APNs) are more prepared to provide theory-based care, particularly in regard to family, chronic disease management, and motivational interviewing. Educational requirements include a more extensive look at the healthcare delivery system, increasing an APN's ability to assist with complex care levels and efficiently arrange for prompt medical referrals when clinical deterioration requires an immediate office visit to prevent reversible, acute exacerbations requiring hospitalization.…”

Section: Need For a Specialized Hf Nurse Educatormentioning

confidence: 99%

Bridging the Gap Between Hospital and Home

Manning

2011

Journal of Cardiovascular Nursing

View full text Add to dashboard Cite

Advanced cardiovascular interventions and an aging population contribute to the growing prevalence of patients with heart failure (HF). Improved medical management, while decreasing mortality, has increased morbidity and cost, with a majority of expense related to preventable hospitalizations. Evidence-based guidelines for discharge instruction, when successfully administered, reduce readmission rates in high-risk HF patients, leading to improved quality of life and economic savings. Unfortunately, effective delivery is complex and time consuming, placing a high demand on already overworked bedside nurses. Failure to provide complete discharge instructions results in nonadherence to treatment regimens and lack of essential follow-up, the most commonly identified reasons for acute HF exacerbations and readmissions. To improve quality of care, hospitals need to adopt a new model that incorporates delivery of intensive, 1-on-1 education to high-risk HF patients during the hospital stay with continuing support, guidance, and education throughout the transition from hospital to home. This can be achieved through implementation of a 2-tiered model that incorporates a risk-assessment tool with utilization of a HF nurse educator. The simple, evidence-based bedside screening tool will allow medical-surgical nurses to quickly identify and refer HF patients at high risk of readmission to a HF nurse educator. With an advanced degree and specialized training, the nurse educator is responsible for providing in-depth discharge teaching and bridging the gap from hospital to home. The end result is improved self-management, increased quality of life, reduced hospital admissions, and an associated decrease in societal costs of HF.

show abstract

“…Nursing decision‐making across a range of clinical judgements and contexts also reveals inconsistency and variability (Dowding, Spilsbury, Thompson, Brownlow, & Pattenden, ; Hoffman, Aitken, & Duffield, ). Decision‐making involves processes of judgement formation and cognitive reasoning (Banning, ; Simmons, ; Standing, ).…”

Section: Introductionmentioning

confidence: 99%