The nature of information gathering and decision-making requires making effective encounters with various patients (Straus, Tetroe, and Graham, 2013; Adams and Drake, 2006; Rynes and Bartunek, 2017). For instance, the perceptions of trust and credibility of the patient towards the nurse may depend upon the confidentiality of the issues raised regarding multiple and conflicting decision goals. The need to build confidence to foster the perceptions of information gathering and decision-making credibility can often be obtained through research utilization, quality improvement, and nursing research.
The Cognitive Continuum
The idea of the cognitive continuum was developed in the early 1960s by cognitive psychologists and decision theorists. In this model, the process of intuitive decision making or rational decision may be engaged through the major determinants of evidence-based decision making (Cader, Campbell, and Watson, 2005; Hamm, 1988; Dhami and Thomson, 2012; Offredy, Kendall, and Goodman, 2008). However, it may depend as to whether a person is capable of performing a certain task such as selecting a nursing intervention. The cognitive continuum is usually composed of three dimensions. These include the complexity of the task, the ambiguity of the task, and form of task presentation.
The complexity of the task: in this dimension, the number of information cues corresponds to the number of judgment or steps that are required to make a decision. These steps may range from selecting interventions for patients with conditions which may be either chronic or comorbid to lack of complete information presented.
The ambiguity of the task: rational information processing can be induced through various task characteristics by "cognitively" organizing principles for collecting and handling information. Furthermore, the decisions may also be simplified in a process known as feedfoward. Other task characteristics can also be applied including a decision task which is familiar with the available content and the availability of an observable outcome in relation to the presented task. Also, the degree to which the feedback of the outcome is presented to determine the success of the task.
A form of task presentation: this dimension is usually based on the existing short time frames which are capable of predicting judgment. Hence, this ensures that the information obtained may be induced on intuitive handling. In other words, a task may be broken down into various components, which in turn, affects the rationality presented on the obtained clinical information.
Nursing research involves a systematic approach regarding nursing knowledge specifically designed to develop, refine, and extend the quality and accuracy if the data as well as related analyses (Moule, Aveyard, and Goodman, 2016; Parahoo, 2014; Fain, 2017). As part of a clinical and professional discipline, nurses have an obligation to acknowledge the nursing practice, administration, and education. This process is often conducted through quantitative, qualitative, or mixed methods. As such, these nursing research methods may involve examining problems related to a specific area of concern such as nurses and the patients, families, and communities they serve.
When conducting nursing research, the scientific method applied may involve collecting observable, measurable, and verifiable data to describe, explain, or predict outcomes in a prescribed manner (Fain, 2017; Cope, 2014). For instance, specific data can be collected for the purpose of examining the effects associated with massage on blood pressure, among other related factors. Often, research methods regard the collected data as objective thus limiting its influence by the researcher's hypotheses, beliefs or values. As a result, this is done to prevent the information from being biased by the results or outcomes. Therefore, researchers are required to construct a plan suitable for developing a study proposal. Furthermore, this plan must minimize the risks that might be presented as well as supporting the reliable information and results regarding their development.
EBP Implications for Nurses
Nurses are often required to develop an integrated approach to ensure the effectiveness of evidence-based practice. Their role is usually associated with achieving desirable outcomes for patients especially by working with other members of the healthcare facility (Stavor, Zedreck-Gonzalez, and Hoffmann, 2017; Bovino et al., 2017; Ruzafa-Martinez et al., 2016). This may include identifying a clinical problem through the application of existing or developed evidence to enhance practice. Also, nurses might be encouraged to develop multidisciplinary efforts to ensure the reduction of potential risks that might be presented. Through the implementation of these evidence-based guidelines, nurses can be able to increase compliance and improve the outcome of the results.
Table: Core Elements of Critical Appraisal
(Krainovich-Miller et al., 2009) (Fineout-Overholt, Melnyk, and Schultz, 2005).
Quality: strength and limitations presented within the applied methods and methodology. Validity: rigor of methods presented.
Quantity: the strength of the findings based on the number and size of the research. Findings: the main ideas obtained from the study.
Consistency: comparing the findings and study design with similar/opposing measures. Applicability: the importance of the results both on a local and international basis.
The Importance of Evidence-Based Practice
High-quality patient care can be obtained through effective evidence-based practice. In most cases, the process may involve gathering efficient research and knowledge regarding questions that may arise from a clinical perspective (Melnyk and Fineout-Overholt, 2011; Titler et al., 2001). For instance, formulating a critical strategy can be considered as appropriate especially when involved in such a practice. In turn, this will ensure that the care delivered is up-to-date and is based upon the recent research evidence.
The term "evidence-based practice/medicine" was developed during the 1980s to evaluate the approach that relied on scientific evidence associated with the best practice. In this context, the evidence is used to present the patient's preferences and desires regarding a particular outcome depending on the clinical situation, and the expertise of the clinician. In nursing practice, "evidence" may be used to guide practice despite the sources not being purely research-based. As such, the main concern often lies within acquiring sufficient knowledge in relation to experience or advice acquired from patients or colleagues. Also, the evidence-based practice can be made easier if an integrated approach is considered. This may include already-developed evidence-base or clinical practice guidelines. Overall, systematic efforts have been developed to ensure the application of effective guidelines so as to assist in healthcare services as well as helping patients make informed decisions.
Adams, J.R., and Drake, R.E., 2006. Shared decision-making and evidence-based practice. Community mental health journal, 42(1), pp.87-105.
Bovino, L.R., Aquila, A.M., Bartos, S., McCurry, T., Cunningham, C.E., Lane, T., Rogucki, N., DosSantos, J., Moody, D., Mealia-Ospina, K. and Pust-Marcone, J., 2017. A Cross-sectional Study on Evidence-Based Nursing Practice in the Contemporary Hospital Setting: Implications for Nurses in Professional Development. Journal for nurses in professional development, 33(2), pp.64-69.
Cader, R., Campbell, S., and Watson, D., 2005. Cognitive Continuum Theory i...
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