Decision analysis in evidence-based children’s nursing: a community nursing perspective



In this chapter, decision analysis is explored as a model in support of the clinical judgement and decision making necessary for the transfer of care from the hospital to the home environment. The need to be able to demonstrate accountability in a health care arena such as community children’s nursing is argued. Decision analysis is suggested as a process that may enable children’s nurses to provide the evidence of their judgement and decision making when working in increasingly complex care settings and within multiprofessional health care teams.


Cystic Fibrosis Home Care Decision Analysis Clinical Judgement Community Child 
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  1. Anderson K. N., Anderson L. E. and Glanze W. D. (1994) Mosby’s Medical, Nursing and Allied Health Dictionary, 4th edn, St Louis, Mosby.Google Scholar
  2. Atwell J. D. and Gow M. A. (1985) ‘Paediatric trained district nurse in the community: expensive luxury or economic necessity?’, British Medical Journal, 291: 227–9.CrossRefPubMedPubMedCentralGoogle Scholar
  3. Baumann A. O., Deber R. B. and Thompson G. G. (1991) ‘Overconfidence among physicians and nurses: the “micro-certainty, macro-uncertainty” phenomenon’, Social Science of Medicine 32 (2): 161–74.CrossRefGoogle Scholar
  4. Benner P. (1984) From Novice to Expert: Excellence and Power in Clinical Nursing Practice, Menlo Park, CA, Addison Wesley.Google Scholar
  5. Blagg N., Ballinger M. and Gardner R. (1988) Somerset Thinking Skills Course, Oxford, Basil Blackwell.Google Scholar
  6. Bond N., Philips P. and Rollins J. A. (1994) ‘Family centered care at home for families with children who are technology dependent’, Pediatric Nursing 20 (2): 123–30.PubMedGoogle Scholar
  7. Catchpole A. (1989) ‘Cystic fibrosis: intravenous treatment at home’, Nursing Times 85 (12): 40–2.PubMedGoogle Scholar
  8. Couriel J. M. and Davies P. (1988) ‘Costs and benefits of a community special care baby service’, British Medical Journal 296: 1043–6.CrossRefPubMedPubMedCentralGoogle Scholar
  9. David J. T. (1986) ‘Potential practical and legal problems with home administration of intravenous antibiotics for children with cystic fibrosis’. In Davis J. T. (ed.) Cystic Fibrosis in Children. Practical and Legal Aspects of Intravenous Antibiotic Administration in the Home, Amsterdam, Elsevier.Google Scholar
  10. Department of Health (1993) Children First–a Study of Hospital Services, London, Audit Commission/HMSO.Google Scholar
  11. Dowie J. (1993) ‘Clinical decision analysis: background and introduction’. In Llewelyn H. and Hopkins A. (eds) Analysing How we Reach Clinical Decisions, London, Royal College of Physicians.Google Scholar
  12. Einhorn H. J. (1980) ‘Overconfidence in judgment. New directions for methodology of social and behavioral science’ New Directions for Methodology of Social and Behavioural Science 4: 1–16.Google Scholar
  13. Ellis J. M. (1989) ‘Let parents give the care: IV therapy at home in cystic fibrosis’, Professional Nurse 4 (12): 589–92.Google Scholar
  14. Elstein A. S. and Bordage G. (1988) ‘Psychology of clinical reasoning’. In Dowie J. and Elstein A. (eds) Professional Judgment: A Reader in Clinical Decision Making, Cambridge, Cambridge University Press, pp. 109–29.Google Scholar
  15. Emden C. (1991) ‘Becoming a reflective practitioner’. In Gray G. and Pratt R. (eds) Towards a Discipline of Nursing, Edinburgh, Churchill Livingstone.Google Scholar
  16. Eraker S. A. and Politser P. E. (1988) ‘How decisions are reached: physician and patient’. In Dowie J. and Elstein A. (eds) Professional Judgement: A Reader in Clinical Decision Making, Cambridge, Cambridge University Press, pp. 379–94.Google Scholar
  17. Fields A. I., Hardy Coble D., Pollock M. M. and Kaufman J. (1991) ‘Outcome of home care for the technology-dependent children’, Pediatric Pulmonology 11: 310–17.CrossRefPubMedGoogle Scholar
  18. Fischhoff B., Slovic P. and Lichtenstein S. (1980) ‘Knowing what you want: measuring labile values’. In Wallsten T. S. (ed.) Cognitive Processes in Choice and Decision Behaviour, USA, Lawrence Erlbaum.Google Scholar
  19. Gill S. (1993) ‘Home administration of intravenous antibiotics to children with cystic fibrosis’, British Journal of Nursing 2 (15): 767–70.PubMedGoogle Scholar
  20. Gordon M., Murphy C. P., Candee D. and Hiltunen E. (1994) ‘Clinical judgement: an integrated model’, Advances in Nursing Science 16 (4): 55–70.CrossRefPubMedGoogle Scholar
  21. Hammond K. R., McClelland G. H. and Mumpower J. (1980) Human Judgement and Decision Making, New York, Hemisphere.Google Scholar
  22. Harbison J. (1991) ‘Clinical decision making in nursing’, Journal of Advanced Nursing 16: 404–7.CrossRefPubMedGoogle Scholar
  23. Hill D. S. (1993) ‘Co-ordinating a multi disciplinary discharge for the technology-dependent child based on parental needs’, Issues in Comprehensive Paediatric Nursing, 16: 229–37.CrossRefGoogle Scholar
  24. Hogue E. (1992) ‘Parental noncompliance in home care’, Pediatric Nursing 18 (6): 603–6.PubMedGoogle Scholar
  25. Klug R. M. (1993) ‘Clarifying roles and expectations in home care’, Pediatric Nursing 19 (4): 374–6.PubMedGoogle Scholar
  26. Komaroff A. J. (1979) The variability and inaccuracy of medical data, Proceedings of IEEE 67: 1196–207.CrossRefGoogle Scholar
  27. Lantos J. D. and Kohrman A. F. (1992) ‘Ethical aspects in pediatric home care’, Pediatrics 89 (5): 920–4.PubMedGoogle Scholar
  28. Luker K. A. and Kendrick M. (1992) ‘An exploratory study of the sources of influence on the clinical decisions of community nurses’, Journal of Advanced Nursing 17: 457–66.CrossRefPubMedGoogle Scholar
  29. McCormack K. (1992) ‘Areas of outcome research in nursing’, Journal of Professional Nursing 8 (2): 71.CrossRefGoogle Scholar
  30. Mehtar S. (1992) Hospital Infection Control, Oxford, Oxford Medical Publications.Google Scholar
  31. Müller D. J., Harris P. J., Wattley L. A. and Taylor J. (1993) Nursing Children: Psychology, Research and Practice ( 2nd edn ), London, Chapman & Hall.Google Scholar
  32. Roberts J., While A. E. and Fitzpatrick J. M. (1993) ‘Problem solving in nursing practice: application, process, skill acquisition and measurement’, Journal of Advanced Nursing 18: 886–91.CrossRefPubMedGoogle Scholar
  33. Roberts J., While A. and Fitzpatrick J. (1995) ‘Information-seeking strategies and data utilisation: theory and practice’, International Journal of Nursing Studies 32 (6): 601–11.CrossRefPubMedGoogle Scholar
  34. Schön D. A. (1991) The Reflective Practitioner ( 2nd edn ), San Francisco, Jossey Bass.Google Scholar
  35. Signorelli C., D’Alessandro D., Collina D. and Fara G. M. (1991) ‘Prevalence survey of nosocomial infections in a paediatric hospital’, Journal of Hospital Infection 18: 139–43.CrossRefPubMedGoogle Scholar
  36. Soden R. (1994) Teaching Problem Solving in Vocational Education, London, Routledge.Google Scholar
  37. Sterling Y. (1990) ‘Resource needs of mothers managing chronically ill infants at home’, Neonatal Work 9 (1): 55–9.Google Scholar
  38. Tversky A. and Kahneman D. (1982) ‘Judgment under uncertainties and biases’. In Kahneman D., Slovic P. and Tversky A. (eds) Under Uncertainty: Heuristics and Biases, Cambridge, Cambridge University Press.Google Scholar
  39. Watson S. (1994) ‘An exploratory study into a methodology for the examination of decision making by nurses in the clinical area’, Journal of Advanced Nursing 20: 351–60.CrossRefPubMedGoogle Scholar
  40. While E. A. (1991) ‘An evaluation of a paediatric home care scheme’, Journal of Advanced Nursing 16: 1413–21.CrossRefPubMedGoogle Scholar
  41. Whyte D. A. (1994) Family Nursing: The Case of Cystic Fibrosis, Aldershot, Avebury.Google Scholar
  42. Zarin D. A. and Pauker S. G. (1984) ‘Decision analysis as a basis for medical decision making: the tree of Hippocrates’, Journal of Medicine and Philosophy 9: 181–213.CrossRefPubMedGoogle Scholar

Further reading

  1. Bakken H. S. (1995) ‘Nursing informatics: state of the science’, Journal of Advanced Nursing 22: 1182–92.Google Scholar
  2. Corcoran S. (1989) ‘Decision analysis: a step-by-step guide for making clinical decisions’, Nursing and Health Care Mar.: pp 149–54.Google Scholar
  3. Edwards B. (1994) ‘Telephone triage: how experienced nurses reach decisions’, Journal of Advanced Nursing 19: 717–24.CrossRefPubMedGoogle Scholar
  4. Gray J. A. Muir (1997) Evidence-based Health Care, Edinburgh, Churchill Livingstone.Google Scholar
  5. O’Neill E. and Dluhy N. M. (1997) ‘A longitudinal framework for fostering critical thinking and diagnostic reasoning’, Journal of Advanced Nursing 26: 825–32.CrossRefPubMedGoogle Scholar
  6. Thomas S., Wearing A. and Bennett M. (1991) Clinical Decision Making for Nurses and Health Professionals, New York, W. B. Saunders/Baillière Tindall.Google Scholar

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