title: Health professionals' decision-making in wound management: a grounded theory.
abstract: OBJECTIVE
  To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice.
  
  
  BACKGROUND
  With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area.
  
  
  METHODS
  A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice.
  
  
  METHODS
  Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes.
  
  
  RESULTS
  The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes.
  
  
  CONCLUSIONS
  These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes.
authors.affiliation: NHMRC Research Centre for Clinical Excellence in Nursing Interventions (NCREN) & Centre for Healthcare Practice Innovation (HPI), Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia.
authors.forename: Brigid M
authors.initials: BM
authors.lastname: Gillespie
authors.affiliation: NHMRC Research Centre for Clinical Excellence in Nursing Interventions (NCREN) & Centre for Healthcare Practice Innovation (HPI), Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia.
authors.forename: Wendy
authors.initials: W
authors.lastname: Chaboyer
authors.affiliation: School of Nursing & Midwifery, Griffith University, Gold Coast Campus, Queensland, Australia.
authors.forename: Winsome
authors.initials: W
authors.lastname: St John
authors.affiliation: Gold Coast Health Services District, Vascular Services, Gold Coast Campus, Queensland, Australia.
authors.forename: Nicola
authors.initials: N
authors.lastname: Morley
authors.affiliation: Division of Surgery Services GCH, Gold Coast Health Service District, Southport, Queensland, Australia.
authors.forename: Paul
authors.initials: P
authors.lastname: Nieuwenhoven
mesh_terms: D001315:Australia; D003657:Decision Making; D006282:Health Personnel; D006801:Humans; D009742:Nursing Theory; D014947:Wounds and Injuries / Q000628:therapy*
keywords: acute care; clinical judgement; evidence-based practice; information access; multidisciplinary; nursing; patient advocate; pharmaceutical marketing; qualitative; ward culture