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Dorothy McCaughan

Publications and source records attributed to Dorothy McCaughan.

9 recordsLinked to original sources
PubMed2005

Nurse practitioner and practice nurses' use of research information in clinical decision making: findings from an exploratory study.

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. CONCLUSION: 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.

Adult↗
PubMed2005

Barriers to evidence-based practice in primary care nursing--why viewing decision-making as context is helpful.

AIM: This paper reports a study examining the barriers associated with research knowledge transfer amongst primary care nurses in the context of clinical decision-making. BACKGROUND: The research literature on barriers to nurses' use of research knowledge is characterized by studies that rely primarily on self-report data, making them prone to reporting biases. Studies of the barriers to evidence-based practice often fail to examine information use and behaviour in the context of clinical decision-making. METHODS: A multi-site, mixed method, case study was carried out in 2001. Data were collected in three primary care organizations by means of interviews with 82 primary care nurses, 270 hours of non-participant observation and 122 Q-sorts. Nurses were selected using a published theoretical sampling frame. Between-methods triangulation was employed and data analysed according to the principles of constant comparison. Multiple linear regression was used to explore relationships between a number of independent demographic variables (such as length of clinical experience) and the dependent variable of nurses' perspectives on the barriers to their use of research knowledge. RESULTS: Three perspectives on barriers to research information use emerged: the need to bridge the skills and knowledge gap for successful knowledge transfer; information formats need to maximize limited opportunities for consumption; and limited access in the context of limited time for decision-making and information consumption. Demographic variables largely failed to predict allegiance to any of the perspectives identified. CONCLUSIONS: Researchers should consider using decision-making as a contextual backdrop for exploring information use and behaviour, avoid relying solely on self-reported behaviour as data, and use a variety of research methods to provide a richer picture of information-related behaviour. Practice developers need to recognize that understanding the decisions to which research knowledge is to be applied should be a characteristic of any strategy to increase research uptake by nurses.

Adult↗
PubMed2004

Increasing the visibility of coding decisions in team-based qualitative research in nursing.

OBJECTIVES: To examine the use of the multi-rater Kappa measure of agreement (Nonparametric Statistics for the Behavioural Sciences, McGraw Hill, New York, 1988) in team based, mixed method, qualitative nursing research. DESIGN: The article presents an illustrative description of the application of the qualitative coding procedure and associated multi-rater Kappa measurement at four time points in 9 months amongst a five person health services research team. MAIN OUTCOME MEASURES: The multi-rater Kappa statistic. This is a measure of the extent to which observers achieve possible agreement beyond any agreement expected to occur by chance alone. RESULTS: Closeness to primary qualitative research data, working relationships over time, and focused research team discussion can all lead to greater agreement and convergence at the level of descriptive coding. The method of measuring agreement between groups of coders was easily applied and appeared a feasible option for similar research projects wishing to demonstrate transparency in their coding procedures. CONCLUSION: Measuring agreement beyond chance by the multi-rater Kappa statistic has some utility for research teams whose qualitative coding tasks are primarily descriptive. The method offers a standard and transparent approach for demonstrating agreement between coders and should be a feature of qualitative research reporting where appropriate.

Abstracting and Indexing↗
PubMed2002

Acute care nurses' perceptions of barriers to using research information in clinical decision-making.

AIM: To examine the barriers that nurses feel prevent them from using research in the decisions they make. BACKGROUND: A sizeable research literature focusing on research utilization in nursing has developed over the past 20 years. However, this literature is characterized by a number of weaknesses: self-reported utilization behaviour; poor response rates and small, nonrandom sampling strategies. DESIGN: Cross-case analysis involving anonymised qualitative interviews, observation, documentary audit and Q methodological modelling of shared subjectivities amongst nurses. The case sites were three large acute hospitals in the north of England. One hundred and eight nurses were interviewed, 61 of whom were also observed for a total of 180 h, and 122 nurses were involved in the Q modelling exercise (response rate of 64%). RESULTS: Four perspectives were isolated that encompassed the characteristics associated with barriers to research use. These related to the individual, organization, nature of research information itself and environment. Nurses clustered around four main perspectives on the barriers to research use: (1) Problems in interpreting and using research products, which were seen as too complex, 'academic' and overly statistical; (2) Nurses who felt confident with research-based information perceived a lack of organizational support as a significant block; (3) Many nurses felt that researchers and research products lack clinical credibility and that they fail to offer the desired level of clinical direction; (4) Some nurses lacked the skills and, to a lesser degree, the motivation to use research themselves. These individuals liked research messages passed on to them by a third party and sought to foster others' involvement in research-based practice, rather than becoming directly involved themselves. CONCLUSIONS: Rejection of research knowledge is not a barrier to its application. Rather, the presentation and management of research knowledge in the workplace represent significant challenges for clinicians, policy-makers and the research community.

Adult↗
PubMedDate not supplied

The value of research in clinical decision-making.

This article examines the application of research-based information in clinical decision-making. In doing so it draws on the findings (and work in progress) of two research projects that seek to contribute to establishing the potential for evidence-based approaches in nursing. The authors conclude that understanding the types of decisions nurses make, their clinical uncertainties and unanswered questions is of value to both researchers, policy makers and practitioners.

Attitude of Health Personnel↗