Enhancing Clinical Decision Making: Development of a Contiguous Definition and Conceptual Framework

Tiffen, Jennifer; Corbridge, Susan J.; Slimmer, Lynda

doi:10.1016/j.profnurs.2014.01.006

Cited by 125 publications

(96 citation statements)

References 27 publications

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“…Clinical decision-making involves making judgments about care provided in health service settings using information or knowledge, and can be defined as “...a contextual, continuous, and evolving process, where data are gathered, interpreted, and evaluated in order to select an evidence-based choice of action” (p.401 [23]).…”

Section: Methodsmentioning

confidence: 99%

mHealth for Clinical Decision-Making in Sub-Saharan Africa: A Scoping Review

Adepoju¹,

Albersen²,

Brouwere³

et al. 2017

JMIR Mhealth Uhealth

134

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BackgroundIn a bid to deliver quality health services in resource-poor settings, mobile health (mHealth) is increasingly being adopted. The role of mHealth in facilitating evidence-based clinical decision-making through data collection, decision algorithms, and evidence-based guidelines, for example, is established in resource-rich settings. However, the extent to which mobile clinical decision support systems (mCDSS) have been adopted specifically in resource-poor settings such as Africa and the lessons learned about their use in such settings are yet to be established.ObjectiveThe aim of this study was to synthesize evidence on the use of mHealth for point-of-care decision support and improved quality of care by health care workers in Africa.MethodsA scoping review of 4 peer-reviewed and 1 grey literature databases was conducted. No date limits were applied, but only articles in English language were selected. Using pre-established criteria, 2 reviewers screened articles and extracted data. Articles were analyzed using Microsoft Excel and MAXQDA.ResultsWe retained 22 articles representing 11 different studies in 7 sub-Saharan African countries. Interventions were mainly in the domain of maternal health and ranged from simple text messaging (short message service, SMS) to complex multicomponent interventions. Although health workers are generally supportive of mCDSS and perceive them as useful, concerns about increased workload and altered workflow hinder sustainability. Facilitators and barriers to use of mCDSS include technical and infrastructural support, ownership, health system challenges, and training.ConclusionsThe use of mCDSS in sub-Saharan Africa is an indication of progress in mHealth, although their effect on quality of service delivery is yet to be fully explored. Lessons learned are useful for informing future research, policy, and practice for technologically supported health care delivery, especially in resource-poor settings.

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Section: Methodsmentioning

confidence: 99%

mHealth for Clinical Decision-Making in Sub-Saharan Africa: A Scoping Review

Adepoju¹,

Albersen²,

Brouwere³

et al. 2017

JMIR Mhealth Uhealth

134

View full text Add to dashboard Cite

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“…Clinical reasoning is a generic term that is commonly referred to as the processes through which information is obtained and interpreted to draw the necessary conclusions for health care. However, other expressions are used interchangeably with clinical reasoning, such as clinical judgment, decision-making process or even critical thinking (5)(6) . Regardless, clinical reasoning is a primary skill in nursing practice because it is through it that professionals identify, prioritize, and establish plans, as well as interpret clinical data (2) .…”

Section: Introductionmentioning

confidence: 99%

Clinical reasoning in undergraduate nursing education: a scoping review

Menezes

Corrêa

Silva

et al. 2015

Rev. esc. enferm. USP

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Objective:This study aimed at analyzing the current state of knowledge on clinical reasoning in undergraduate nursing education. Methods: A systematic scoping review through a search strategy applied to the MEDLINE database, and an analysis of the material recovered by extracting data done by two independent reviewers. The extracted data were analyzed and synthesized in a narrative manner. Results: From the 1380 citations retrieved in the search, 23 were kept for review and their contents were summarized into five categories: 1) the experience of developing critical thinking/clinical reasoning/decision-making process; 2) teaching strategies related to the development of critical thinking/clinical reasoning/decision-making process; 3) measurement of variables related to the critical thinking/clinical reasoning/decision-making process; 4) relationship of variables involved in the critical thinking/clinical reasoning/decisionmaking process; and 5) theoretical development models of critical thinking/clinical reasoning/decision-making process for students. Conclusion: The biggest challenge for developing knowledge on teaching clinical reasoning seems to be finding consistency between theoretical perspectives on the development of clinical reasoning and methodologies, methods, and procedures in research initiatives in this field.

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“…However, even if we drawevidence from the topofthe pyramid, we nevertheless find that in the Tiffen et al (2014) conceptual review,there was conflicting evidence about the effectiveness of technological expertise in the published reviews and whether or not it contributed to efficiency, certainty,r ationalization of diagnosis, and managemento fc linical problems. Randell, Mitchell, Dowding,C ullum, and Thompson(2007)found that the impactonperformance and patientoutcomes of nurses' technologically informed decision making was inconsistent.…”

Section: Technology/technological Expertise In Clinical Decision Makingmentioning

confidence: 79%

“…Astudy conducted by Tiffen, Corbridge and Slimmer (2014) to develop adefinition and framework for clinical decision making involved aliterature review and aseries of interactive panels. The final definition proposed by the authors incorporated the characteristics of practitioners and their situations as well as the dynamic natureofthe process.…”

Section: Technology/technological Expertise In Clinical Decision Makingmentioning

confidence: 99%