2020
DOI: 10.1111/jocn.15524
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Nurses' protocol‐based care decision‐making: a multiple case study

Abstract: Aim: To describe and explain nurses' protocol-based care decision-making. Background: Protocol-based care is a strategy to reduce variability in clinical practice. There are no studies looking at protocol-based care decision-making. Understand this process is key to successful implementation. Method: A multiple embedded case study was carried out. Nurses' protocol-based care decision-making was studied in three inpatient wards (medical, surgical and medical-surgical) of a university hospital in northern Spain.… Show more

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Cited by 11 publications
(7 citation statements)
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“…32 With their training and clinical expertise, CNSs support nurses and promote improvements in clinical practice, with their leadership constituting a driving force to promote processes of change and innovation and the translation of knowledge into clinical practice. 8,33,34 In this sense, and returning to the finding regarding the improvement of nurses' clinical evidence-based decision-making, this study reinforces the results of a recent study 35 about the impact of CNSs on improving decision-making processes in the standardization of care. The findings of this study suggest that the CNS facilitates nurses' self-reflection on the way they work.…”
Section: Discussionsupporting
confidence: 85%
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“…32 With their training and clinical expertise, CNSs support nurses and promote improvements in clinical practice, with their leadership constituting a driving force to promote processes of change and innovation and the translation of knowledge into clinical practice. 8,33,34 In this sense, and returning to the finding regarding the improvement of nurses' clinical evidence-based decision-making, this study reinforces the results of a recent study 35 about the impact of CNSs on improving decision-making processes in the standardization of care. The findings of this study suggest that the CNS facilitates nurses' self-reflection on the way they work.…”
Section: Discussionsupporting
confidence: 85%
“…The CNS guides, questions, explains based on evidence the best alternative, and fosters a critical attitude, which is crucial for encouraging nurses to consider different lines of action and not to act automatically. 35 Advanced training is an aspect that the nurses highlighted as key to the CNS's ability to perform their functions. However, internationally, there is no uniformity in the level of education required for advanced practice positions.…”
Section: Discussionmentioning
confidence: 99%
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“…However, the low number of RRS events where physicians/APP responded ( n = 6) does not support physician/APP presence as an explanation for low protocol use. Nurse-led care protocols are regarded as empowering (Olson-Sitki et al, 2015; Rohlik et al, 2021) but adoption into clinical practice varies by care setting (Blodgett & Sheets, 2021), years of clinical experience (Blackwood & Wilson-Barnett, 2007), and degree of risk associated with the clinical activity (Vázquez-Calatayud et al, 2020). Use of care protocols by RRTs has not been described in the literature before and is an exciting intervention for consideration in future investigation by RRS researchers.…”
Section: Discussionmentioning
confidence: 99%
“…Formar de manera continuada a todo el personal sanitario en los PZ, especialmente el de nueva incorporación, mediante la formación online organizada, casos prácticos y simulación, entre otros. Incidir también en la concienciación y la capacitación de los profesionales para evaluar con precisión el grado de riesgo de la actividad clínica si no cumplen con las medidas 12 . 2.…”
Section: Conclusionesunclassified