title: Nurse practitioner and practice nurses' use of research information in clinical decision making: findings from an exploratory study.
abstract: BACKGROUND
  There is a lack of evidence regarding the kinds of decisions made by primary care nurses and the information sources they use in clinical decision making.
  
  
  OBJECTIVE
  To describe the decisions made by nurses working in general practice and the sources of information they use to underpin those decisions.
  
  
  METHODS
  Qualitative methods (interviews, observation, documentary analysis) were used to collect data on the clinical decision making and information seeking behaviour of a purposive sample of 29 practice nurses and four nurse practitioners from general practices in the North of England. Data were collected November 2001-September 2002.
  
  
  RESULTS
  A seven-fold typology captured the types of decisions the nurses made on a daily basis concerning assessment, diagnosis, intervention, referral, communication, service delivery and organization (SDO) and information seeking. Faced with clinical uncertainty, the majority of the nurses in the study relied on personal experience, or obtained advice and information from GP or other colleagues. These 'human sources' of information were overwhelmingly preferred to text or on-line resources. Despite encounters with evidence-based resources through continuing professional development, the nurses rarely used them to seek answers to routine clinical questions.
  
  
  CONCLUSIONS
  The decisions of the nurses in the study were mainly concerned with undifferentiated diagnosis and treatment, in the context of acute conditions and chronic disease management. 'Human sources' of information were preferred to any other; however, we do not know whether information obtained from colleagues is based on research.
authors.affiliation: Department of Health Sciences, Seebohm Rowntree Building, University of York, Heslington, UK. dmm5@york.ac.uk
authors.forename: Dorothy
authors.initials: D
authors.lastname: McCaughan
authors.forename: Carl
authors.initials: C
authors.lastname: Thompson
authors.forename: Nicky
authors.initials: N
authors.lastname: Cullum
authors.forename: Trevor
authors.initials: T
authors.lastname: Sheldon
authors.forename: Pauline
authors.initials: P
authors.lastname: Raynor
mesh_terms: D000328:Adult; D003657:Decision Making; D005194:Family Practice; D005260:Female; D006302:Health Services Research; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009722:Nurse Practitioners; D015399:Nursing Research; D009743:Nursing, Practical; D012106:Research