An observational study of health professionals' use of evidence to inform the development of clinical management tools.
OBJECTIVE
This observational study sought to investigate the process of evidence use by health professionals during development of evidence-based clinical management tools.


BACKGROUND
Studies conducted to explore the process of research use are scarce and knowledge of this process is essential for our understanding of the influences on research use in practice.


METHODS
A qualitative, non-participant, observational design.


METHODS
Behaviour and actions of two separate multidisciplinary teams were observed and audio-recorded during a combined total of seven meetings for the development of clinical management tools. Semi-structured, one-to-one interviews were conducted approximately half-way through the development process and following completion of the clinical management tools.


RESULTS
Three major themes emerged from this research. First, the process of clinical management tool development and evidence use. Nurses assumed responsibility for coordination of development which focused on describing current practice. Second, the forms of evidence employed during the development process included the use of experiential knowledge, opinions and knowledge of the context, in addition to research evidence. However, reference to research evidence was limited and its incorporation into the instrument was infrequently observed. Third, the use of research evidence emerged with respect to how such evidence was employed.


CONCLUSIONS
This study focused on real-life discussion and decision-making that occurred between health professionals when developing evidence-based clinical management tools. Health professionals may have a tendency to rely on their professional experience and current practice in preference to seeking and applying relevant research evidence.


CONCLUSIONS
Nurses have an important role to play in the development of multidisciplinary evidence-based clinical management tools, but to actively participate in this process they need to be familiar with the relevant research evidence and have the skills and confidence to integrate the evidence into practice.
Hutchinson
Alison M
AM
School of Nursing, The University of Melbourne, Victoria, Australia. alison.hutchinson@ualberta.ca
Johnston
Linda
L
D001291:Attitude of Health Personnel; D001315:Australia; D002983:Clinical Competence; D002985:Clinical Protocols; D003299:Cooperative Behavior; D019091:Critical Pathways / Q000458:organization & administration*; D003659:Decision Making, Organizational; D004059:Diffusion of Innovation; D019317:Evidence-Based Medicine / Q000193:education / Q000458:organization & administration*; D001068:Feeding and Eating Disorders / Q000628:therapy; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033183:Interdisciplinary Communication; D007400:Interprofessional Relations; D007410:Intestinal Diseases / Q000628:therapy; D019359:Knowledge; D024802:Nurse's Role / Q000523:psychology; D015404:Nursing Methodology Research; D009741:Nursing Staff, Hospital / Q000193:education / Q000458:organization & administration / Q000523:psychology; D010348:Patient Care Team / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D036301:Qualitative Research; D020377:Self Efficacy; D011795:Surveys and Questionnaires