Biomedical subjects

D Lamond

Publications and source records attributed to D Lamond.

8 recordsLinked to original sources

PubMed2000

The information content of the nurse change of shift report: a comparative study.

The information content of the nurse change of shift report: a comparative study This study examines the role which the nursing change of shift report may have in aiding nurses to process information and plan care. It also aims to identify whether any of the information found in the shift report can be considered as 'forceful feature' information, the key features of a situation which allow an individual to access appropriate knowledge within their long-term memory store. The content of the medical notes, nursing documentation and shift reports for a total of 60 patients, selected from two acute medical and two acute surgical wards across two National Health Service Hospital Trusts in south-east England were subjected to content analysis. The types and amount of information contained in each source were examined, along with the order of information given in the shift reports. A multidimensional scalogram analysis (MSA) was also carried out on the data to examine the patterns of information content across sources. In general, more information was recorded in the patients' notes than communicated during the shift report. However, both the frequency data and the MSA plots indicated that particular types of information (identified here as global judgements) were often communicated in the shift report but not recorded in the patient notes. The results suggest that there is evidence that the change of shift report contains 'forceful feature' information. The presence of such 'forceful features' may facilitate the processing of patient information during the shift report communication, leading to more efficient care planning.

Adult↗

PubMed2000

Intuition and analysis in decision making and choice.

PURPOSE: To discuss the need for a shift in focus from intuitive to more analytic ways of examining both the process and outcomes of professional decisions based on "best evidence." SCOPE: Different assumptions inherent in intuitive and analytic explanations of nurses' decision making are outlined, and the two approaches are compared. The benefits and limitations of such approaches to decision making in nursing and health care are discussed, using available research evidence to show that in most instances the analytical approaches are more effective. CONCLUSIONS: A systematic approach to decision making in health care is needed, so that both health professionals and patients have a means for knowing the basis of decisions about treatment.

Decision Making↗

PubMed1999

The home as a workplace: work-family interaction and psychological well-being in telework.

Home-based telework is a growing phenomenon with great potential to affect employees' psychological well-being. Although prior studies show both positive and negative effects on work-family interaction, conclusions are limited by the way telework, well-being, and work-family interaction have been modeled. The authors present a conceptual framework that describes telework as a multidimensional phenomenon and separates the effects of the home environment from those of distance from the organization. Propositions concerning work-family interaction are developed from P. Warr's (1987) model of the environmental antecedents of well-being, prior telework studies, and the work-family literature. Spillover between work and nonwork domains of well-being is discussed, and suggestions for future research on this complex issue are presented.

Family Relations↗

PubMed1998

The treatment of pressure sores: a comparison of novice and expert nurses' knowledge, information use and decision accuracy.

The knowledge experts have and the way it is organized is thought to affect their decision accuracy and the information they use to make decisions. This exploratory study examines the information used by experts, the way they organize their knowledge and their decision accuracy when considering treatments for pressure sores. A convenience sample of 14 subjects (seven experts and seven novices) were given a card sorting task and a decision task. The cards for the sort contained photographs of pressure sores and various dressings, which the subjects had to place into meaningful categories. In the decision task they were given a photograph of a pressure sore, together with various items of information which could be used to make a decision about the appropriate treatment for the pressure sore. The accuracy of the subjects' decisions were compared to a 'gold standard' decision formulated by an expert panel. Results indicated that experts were more accurate in their choice of treatments in the decision task, and also focused on specific items of information to make their decisions. The accuracy of their decisions was not linked to the categorization strategy used in the card sorts. The findings from this study indicate that more research into the way in which such treatment decisions are undertaken needs to be carried out. Specifically, the way in which education into wound care treatments affects decision accuracy needs to be identified, and ways of aiding individuals to focus on relevant information explored.

Adult↗

PubMed1996

Information sources used in decision making: considerations for simulation development.

Simulation tasks, together with think aloud techniques are often used to research the cognitive processes individuals go through when making a decision or solving a problem. They have been utilised to a certain degree within nursing. A study was carried out to try and identify the sources of information nurses in acute medical and surgical wards used to make assessment judgements. A sample of 114 nurses were interviewed, and their responses analysed using content analysis. Four main sources of information were identified, with verbal interaction being the source of information most frequently mentioned by the subjects. The content of material presented in simulations is normally tested using techniques such as expert panels. However, this paper suggests that of equal importance may be the form of presentation or source of that information. It is suggested that in order to increase the validity of information obtained from simulation tasks, the form of presentation of information to the subject should also be considered.

Clinical Nursing Research↗

PubMed1996

Overview and critique of judgement and decision making in health care: social and procedural dimensions.

This paper presents an outline of the scope for the application of decision theory to health care. Firstly, the main approaches to and assumptions of decision theory are discussed. Secondly, health care decision making is reviewed. It is noted that decision theory can be applied to either the health care professional or to the lay person. Applications of decision theory to clinical practice, to the management of care and to resourcing are considered. Thirdly, some areas which would repay further research are identified. These include social processes in individual and group decision making, the temporal distribution of outcomes and the development of techniques capable of dealing with the complex and dynamic features of decisions. On the basis of the foregoing, some conclusions are drawn.

Decision Making↗

PubMed1996

Judgements and processes in care decisions in acute medical and surgical wards.

The decisions which health care professionals make are the basis of treatment and care given. In order to evaluate effective care it seems logical to suggests that an awareness of the decisions which health care professionals make and how they make them is needed. This study examines the processes nurses use when making decisions about the health care needs of acutely ill patients. In stage one, 104 qualified nurses were interviewed to identify how they decide health care needs. In stage two, a 'think aloud' technique was used with patient simulations to obtain verbal protocols from a further 55 qualified nurses to identify the information strategies they used when making these decisions. The results suggest that nurses base their health care decisions mainly on their assessment of qualitative patient states or conditions. Initial indications are that the processes used differ from those characterized in the diagnostic reasoning model, with the context in which decisions are made being an important influence together with nurses' experience. It is suggested that, in order to develop effective predictive models and clinical guidelines which aid decision making, more research into the nature of health care professionals' decision making is carried out.

Critical Care↗

PubMed1995

The cognitive component of nursing assessment: an analysis.

This paper presents an analysis of the cognitive component of nursing assessment, complimenting the growth in knowledge of other important aspects of assessment. The purpose of the paper is to provide a framework for understanding how nurses structure assessment problems and the types of judgements they make. The thrust of the analysis is based on a comparison between nursing assessment and medical diagnosis, since the cognitive component and judgements formed in medical diagnosis have been more fully articulated. The results suggest that there may be similarities between the cognitive strategies used in nursing assessment and those used in medical diagnosis, particularly in relation to the gathering and organization of information. But the purpose of the information search appears to be different. In medical diagnosis the aim is to establish an explanation for the patient's presenting problem. In nursing assessment, on the other hand, the aim appears to be to provide an accurate picture of the patient's current condition or situation. The assessments formulated fit the definition of a judgement and, in common with medical diagnoses, include some form of prediction. Unlike the medical diagnoses, however, which usually remain stable throughout treatment, the assessments need to change as the patient's condition changes. The cognitive component of assessment has significant implications for nurse education and clinical practice. Further understanding of how nurses structure assessment problems and formulate judgements is therefore needed. The findings may also help to clarify the meaning of nursing diagnosis.

Cognition↗