Conclusion.
NHS policy has increasingly steered nurses (in common with all healthcare professionals) towards a greater awareness of the value of using research based knowledge in clinical decisions. This external (to nursing) NHS policy imperative has been mirrored by the (internal) professional awareness that the use and development of research based knowledge within nursing is central to its own professionalisation ‘project’. More recently the opportunities for nursing research offered by the growth of the NHS Research and Development Strategy (NHS R&D), and the positive impact it offers for meeting the knowledge needs of UK healthcare professionals, as well as the regulatory imperatives imposed by NICE, CHI and the National Service Frameworks have given nursing’s efforts a renewed impetus.
However, there is little good quality research literature to draw on to tell us how nurses access research based information, what stops them using research in practice and how useful it is in helping resolve the uncertainty associated with clinical decisions. Indeed, there is little regarding those decisions made by nurses at all. The literature suggests four clusters of variables which may impact on the ways in which nurses use information in the context of clinical decisions: professional-cultural; environmental; individual decision maker and information related. It suggests that decisions are social creations in which issues of power, demography and culture, as well as rational or intuitive knowledge application, play a part. These characteristics lead to the need for a rich qualitative description of:
. how nurses access research based information
. what nurses perceive as the barriers to their using research based information
. how useful existing sources of information are for clinical decision making
. the decisions that nurses make in practice and the potential for research based information to contribute to the quality of those decisions.
The description needs to reflect the social context and nature of the reality of decision making in organisational settings and be able to build this into its analyses and conclusions. For this reason, a case site approach was chosen with a detailed theoretical approach to sampling informants and data collection.
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