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Summary
Clinical decision-making is an integral part of the professional nurse's role. This literature review aims to determine the present evidence available on clinical decision-making in cardiac nursing and to determine implications for practice and future research in this field.
Keywords
Cardiac nursing; Clinical decision-making; Literature review
These keywords are based on the subject headings from the British Nursing Index. This article has been subject to double-blind review. For author and research article guidelines visit the Nursing Standard home page at www.nursing-standard.co.uk. For related articles visit our online archive and search using the keywords.
NURSES ARE the only occupational group in the NHS to provide 24-hour bedside care and thus have great opportunity to apply their knowledge to meet patients' needs (Hurst 1993). In addition, nurses are usually the first to observe any rapid deterioration in a patient's physical state and it is the nurse's interpretation of events that determines subsequent action. This, combined with the increased responsibility associated with technology and specialisation, demands that nurses be effective clinical decision-makers (Boney and Baker 1997). In cardiac nursing, the decisions the nurse will face can range from routine to life or death. Patient conditions change quickly and thus nurses assume a decision-making role in an emergency situation. Consequently, clinical decision-making is an integral component of the role of the professional nurse.
Literature search strategy
The body of research on decision-making is large and complex. A thorough search was conducted of the relevant published English literature on clinical decision-making in cardiac nursing. Searches of the Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medline, the National Library of Medicine's service, were conducted via CD-ROM. Primary search words used were 'clinical decision-making'. Secondary search words used included'cardiac nursing practice', and 'cardiac nursing education'. The search strategy covered the period from 1985 to 2004 and identified 687 articles.
Original research reports and literature reviews were considered relevant for inclusion in this review. Two specific questions asked of each literature review cited were: was it comprehensive, and was it a critical evaluation of the available literature?
Five specific questions asked of each published study cited were: Was the study clear, concise and relevant? Were the objectives and methods of the study clearly stated? Was the research design...