Influences that drive clinical decision-making among rheumatology nurses. Part 1: literature review

Knowledge sources for evidence-based practice in rheumatology nursing

As rheumatology nursing develops and extends, knowledge about current use of knowledge in rheumatology nursing practice may guide discussions about future knowledge needs. To explore what perceptions rheumatology nurses have about their knowledge sources and about what knowledge they use in their practice, 12 nurses working in specialist rheumatology were interviewed using a semi-structured interview guide. The data were analyzed using conventional qualitative content analysis. The analysis yielded four types of knowledge sources in clinical practice: interaction with others in the workplace, contacts outside the workplace, written materials, and previous knowledge and experience. Colleagues, and physicians in particular, were important for informal learning in daily rheumatology practice. Evidence from the medical arena was accessed through medical specialists, while nursing research was used less. Facilitating informal learning and continuing formal education is proposed as a way toward a more evidence-based practice in extended roles.

Influences that drive clinical decision making among junior rheumatology nurses: a qualitative study

This paper presents a qualitative study exploring the influences that drive clinical decision making among a small group of junior rheumatology nurses.A qualitative, descriptive design was chosen. Semi-structured interviews were used with a purposive sample of six junior staff nurses from two inpatient rheumatology wards in a large teaching hospital in the North of England. The interviews were audiotaped and transcribed using Burnard's (1991) thematic content analysis. The findings demonstrate four distinct themes which influence clinical decision making including professional development, patient-focused care, working in a specialty and rheumatology nursing. Development of experiential knowledge alongside access to specialized information and expert practitioners was also influential in informing decisions.