term paper

critical thinking wound care

Health professionals' decision-making in wound management: a grounded theory

Affiliations.

  • 1 NHMRC Research Centre for Clinical Excellence in Nursing Interventions (NCREN) & Centre for Healthcare Practice Innovation (HPI), Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia.
  • 2 School of Nursing & Midwifery, Griffith University, Gold Coast Campus, Queensland, Australia.
  • 3 Gold Coast Health Services District, Vascular Services, Gold Coast Campus, Queensland, Australia.
  • 4 Division of Surgery Services GCH, Gold Coast Health Service District, Southport, Queensland, Australia.
  • PMID: 25522802
  • DOI: 10.1111/jan.12598

Aim: To develop a conceptual understanding of the decision-making processes used by healthcare professionals in wound care practice.

Background: With the global move towards using an evidence-base in standardizing wound care practices and the need to reduce hospital wound care costs, it is important to understand health professionals' decision-making in this important yet under-researched area.

Design: A grounded theory approach was used to explore clinical decision-making of healthcare professionals in wound care practice.

Methods: Interviews were conducted with 20 multi-disciplinary participants from nursing, surgery, infection control and wound care who worked at a metropolitan hospital in Australia. Data were collected during 2012-2013. Constant comparative analysis underpinned by Strauss and Corbin's framework was used to identify clinical decision-making processes.

Findings: The core category was 'balancing practice-based knowledge with evidence-based knowledge'. Participants' clinical practice and actions embedded the following processes: 'utilizing the best available information', 'using a consistent approach in wound assessment' and 'using a multidisciplinary approach'. The substantive theory explains how practice and evidence knowledge was balanced and the variation in use of intuitive practice-based knowledge versus evidence-based knowledge. Participants considered patients' needs and preferences, costs, outcomes, technologies, others' expertise and established practices. Participants' decision-making tended to be more heavily weighted towards intuitive practice-based processes.

Conclusion: These findings offer a better understanding of the processes used by health professionals' in their decision-making in wound care. Such an understanding may inform the development of evidence-based interventions that lead to better patient outcomes.

Keywords: acute care; clinical judgement; evidence-based practice; information access; multidisciplinary; nursing; patient advocate; pharmaceutical marketing; qualitative; ward culture.

© 2014 John Wiley & Sons Ltd.

Publication types

  • Research Support, Non-U.S. Gov't
  • Decision Making*
  • Health Personnel*
  • Nursing Theory*
  • Wounds and Injuries / therapy*

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