6.2.3 How nurses use technology to support their decision making: The role of experience (358)

Natasha Mitchell, Research Fellow, Health Sciences, University of York, Heslington, United Kingdom Co authors: Rebecca Randell, Rebecca Foster, Dawn Dowding, Val Lattimer, Carl Thompson, Nicky Cullum & Rebecca Owens nm513@york.ac.uk

Abstract:

Background:

Previous research has shown that the experience of a decision maker with a particular decision influences how they use information, and that experience using a technology may influence how that technology is used(O'Cathain et al., 2004). This paper will draw on results from a Department of Health (England) funded study which examined how nurses use technology to support their decision making, to explore how nurses’ experience impacts on their use of such technology.

Methods:

Data were drawn from two sources; a secondary analysis of existing data sets and a case site study of nurses’ use of Computerised Decision Support Systems (CDSS) from 4 NHS Trusts in England. Data sets for the secondary analysis were taken from a study examining primary care nurses’ use of evidence to inform their decision making (410 observations and 76 interviews) (Thompson et al., 2005), and an evaluation of The Exemplar Programme for Out-of-Hours care (55 interviews) (Lattimer et al., 2004). The case site data consisted of non-participant observation of nurses use of CDSS (n=124) and semi-structured interviews with nurses (n=55). Secondary data was analysed using framework analysis and case site data were analysed using content analysis.

Results:

Both nurses clinical experience with a particular type of decision, and their experience using the technology were factors in how technology was used. Nurses were less likely to use decision support systems for decision tasks they were familiar with. Nurses who were experienced using a technology reported ‘internalising’ the knowledge contained within it, so that they used it to guide their decision making without actually referring to it.

Discussion:

Individual nurses may use decision support technologies in different ways, depending on their experience with the decision they are facing and the technology they are using. This has implications for how we investigate the impact of such technologies on patient care.

Recommended reading list:

  • Lattimer, V., Gerard, K., George, S., Smith, H., Lathlean, J., Burgess, A., Turnbull, J. & Surridge, H. (2004) The Exemplar Programme for Integrated Out-of-Hours Care: Evaluation Report. University of Southampton
  • O’Cathain, A., Sampson, F.C., Munro, J.F., Thomas, K.J. & Nicholl, J.P. (2004) Nurses’ views of using computerized decision support software in NHS Direct. Journal of Advanced Nursing, 45, 280-286
  • Thompson, C., McCaughan, D., Cullum, N., Sheldon, T. & Raynor, P. (2005) Barriers to evidence-based practice in primary care nursing – why viewing decision making as a context is helpful. Journal of Advanced Nursing, 52, 432-444

Source of Funding: Other

Amount in Funding: 100,001 - 500,000

Biography:

Natasha Mitchell is a research fellow at the University of York. Her background is in health psychology and she completed her PhD in patient perceptions of myocardial infarction. She has experience in using both quantitative and qualitative methods. Natasha has been working on a Department of Health funded project exploring nurses’ use of computerised decision support systems. Her current research interests include, the design and evaluation of technology within healthcare, nurse prescribing and nurse decision making.