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Nurses' Uncertainty in Decision‐Making: A Literature Review
Author(s) -
Cranley Lisa,
Doran Diane M.,
Tourangeau Ann E.,
Kushniruk André,
Nagle Lynn
Publication year - 2009
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/j.1741-6787.2008.00138.x
Subject(s) - cinahl , viewpoints , heuristics , medline , context (archaeology) , nursing literature , psychology , nursing , medicine , computer science , alternative medicine , psychological intervention , art , paleontology , pathology , political science , law , visual arts , biology , operating system
Aim: This paper is a report of the results of a review of the literature conducted with the goal of determining how nurses' clinical uncertainty has been conceptualized in the nursing literature. Background: Although existing research has advanced the body of knowledge regarding the concept of uncertainty in decision‐making, this has been largely from physicians' viewpoints and from patients' perspectives (patients' uncertainty). Understanding how nurses' experience and act on uncertainty remains relatively unreported. Method: A search of Medline, CINAHL, and PubMed databases was conducted to retrieve literature published from 1990 to 2007. The question guiding the literature review was: How has nurses' clinical uncertainty been conceptualized in nursing literature? Findings: Little exploration has been done of nurses' experience of uncertainty in practice. Many investigators have not theorized about the uncertainty in their studies, but have described nurses' uncertainty in the context of clinical decision‐making. The findings from these studies indicated that unfamiliarity with the aspects of patient care is a source of uncertainty, and nurses tended to rely on heuristics or on the expertise of colleagues as sources of information for practice decisions. Expressing uncertainties as information needs might help guide information seeking and reduce uncertainty. However, studies indicated that nurses have difficulty recognizing or expressing uncertainties, and as a result, information needs are not recognized and information seeking is not initiated. Conclusions: A more comprehensive understanding of nurses' uncertainty could lead to the development and implementation of strategies to support nurses in their clinical decision‐making and practice. Descriptions are needed about how nurses experience and respond to uncertainty in their practice, and the influence of uncertainty on their information needs and information seeking.