Clinical Decision-Making in Nursing Based on Sound Evidence

Friday, 16 July 2010: 8:30 AM

Chaya Balik, RN, PhD
Nursing Department- Tel Aviv University, Shoenbrun Academic School of Nursing, Tel Aviv Medical Center, Tel Aviv, Israel
Shoshana Kelishek, MPA, CNM, RN
Shoenbrun Academic School of Nursing, Shoenbrun Academic School of Nursing, Tel Aviv Medical Center, Tel Aviv, Israel
Yehudith Marcus, MA, RN
Nursing Program, Shoenbrun Academic School of Nursing, Tel Aviv Medical Center, Tel Aviv, Israel
Miriam I. Siebzehner, PhD
The Israeli Center for Technology Assessment in Health Care, Ministry of Health, Israel, Tel-Hashomer, Israel

Learning Objective 1: The learner will be able to learn about the attitudes and knowledge of academic nurses in postgraduate training programs towards evidence-based practice (EBP).

Learning Objective 2: The learner will be able to learn about what extent do nurses retrieve and use professional electronic information resources in their work.

Background:
It is believed that clinicians whose work is based on evidence from applied research will provide better care than those who rely only on their own experience. Therefore, the personal and professional responsibility of nurses treating patients is to base their clinical decision-making on sound evidence (Evidence Based Nursing Practice).
Study questions:
  1. To evaluate the attitudes and knowledge of academic nurses in postgraduate training programs towards EBP.
  2. To what extent do nurses retrieve and use professional electronic information resources in their work.
Methodology:
The study included a convenience sample of 188 graduate nurses attending postgraduate courses. A self-reported questionnaire was developed gathering data on: demographic information, attitudes and level of knowledge of EBP, utilization of nursing information resources during work shifts and leisure time, feelings of confidence in clinical decision-making based on available reported research findings, and the pragmatic EBP support provided by healthcare managers.
Results:
A total of 167 nurses completed the questionnaires. The majority reported using Google and Medline, and some nurses also used Cochrane databases. They retrieved data from the Internet to support their clinical decisions both during their shifts and  their leisure time (rp=.441, p=.000). Their attitude and training in evaluating research correlated significantly with their confidence in the validity of the research (rp=.635, p=.000).
Conclusion:
Nurses reported extensive utilization of both traditional and modern technological sources of information. They have a positive attitude towards their confidence in knowing how to properly evaluate research.
Health Policy implications:
The results of this survey support the development of skills in information retrieval and implementation as an integral part of EBP. When incorporated within the framework of training nurses at all levels of graduate, specialist training, and continuing education programs in health settings, this will enhance the clinical decision-making process for the benefit of patients.