Department of Nursing and Health Care Studies, Institute of Technology, Tralee, Co Kerry, Ireland.
J Adv Nurs. 2012 Feb;68(2):379-90. doi: 10.1111/j.1365-2648.2011.05750.x. Epub 2011 Jun 24.
This paper is a report of a study on how nurses inform their decision-making in the workplace.
Despite the growing availability of research evidence, nurses have been slow to adopt it into their daily decision-making.
The study was undertaken in Ireland between 2006 and 2007 using a sequential mixed methods approach. In phase 1, the views of a quota sample of 29 nurses were explored using semi-structured interviews incorporating vignettes. Phase 2 involved the design and dissemination of a survey to a disproportionate stratified random sample of 1356 nurses. The response rate was 29%.
In decision-making, nurses accessed other people, especially nursing colleagues, the most frequently. Sources that provided prepackaged information such as guidelines were favoured over sources that provided access to original research. The process of information-seeking for routine and non-routine decisions was different. Nurses making routine decisions relied mostly on their experience and an assessment of the patient. In non-routine decision-making, participants experienced more uncertainty about their decisions. Accordingly, sources of information used were more varied and the information-seeking process more extensive. The study highlighted the complexities of establishing whether information used in decision-making is research based or not.
Routine practices should be reviewed and updated regularly through organizational mandates, as nurses do not generally question them. Research information to inform non-routine decision-making must be easily available to nurses in their workplace, as information searches generally prioritize finding enough, rather than the best, information to make a decision.
本文报告了一项关于护士如何在工作场所做出决策的研究。
尽管研究证据越来越多,但护士在将其纳入日常决策方面一直进展缓慢。
该研究于 2006 年至 2007 年在爱尔兰进行,采用顺序混合方法。在第 1 阶段,通过包含情景模拟的半结构化访谈,探讨了 29 名护士的配额样本的观点。在第 2 阶段,设计并向 1356 名护士的不成比例分层随机样本分发了一项调查。回复率为 29%。
在决策中,护士最常求助于其他人,尤其是护理同事。他们更喜欢提供预制信息的来源,如指南,而不是提供原始研究的来源。常规和非常规决策的信息搜索过程不同。做出常规决策的护士主要依赖于他们的经验和对患者的评估。在非例行决策中,参与者对自己的决策感到更加不确定。因此,使用的信息来源更加多样化,信息搜索过程更加广泛。该研究强调了确定决策中使用的信息是否基于研究的复杂性。
应通过组织命令定期审查和更新常规做法,因为护士通常不会对其提出质疑。必须在护士的工作场所中为非例行决策提供易于获取的研究信息,因为信息搜索通常优先找到足够的信息,而不是最好的信息来做出决策。