Date of Award

12-2011

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Program

Nursing

Research Advisor

Cynthia K. Russell, PhD, RN

Committee

Pamela D. Connor, PhD Christine Curran, PhD, RN Leslie M. McKeon, PhD, CNL, NEA-BC Carol L. Thompson, PhD, DNP, ACNP, FNP, FCCM, FAANP Tami Wyatt, PhD, RN, CNE

Keywords

clinical research evidence-based practice focus groups information appraisal information literacy nursing informatics

Abstract

Information appraisal is foundational to information literacy, a necessary skill to support evidence-based practice. Little discussion in nursing literature exists regarding how nurses appraise information. If nurses lack information appraisal skills they cannot safely and effectively apply evidence in practice. Furthermore, if nurses at all levels are to engage in evidence-based practice, information appraisal in the clinical setting must be understood. The research study used an interpretive description design to define and describe the process of information appraisal in the clinical setting. Participants of this study represented a stratified purposeful sample of 44 registered nurses employed at a regional medical center in west Alabama. Most participants were middle-aged women who were licensed an average of 16 years. Emphasis was placed on how nurses describe and evaluate information as they critically reflect on acquired information in the clinical setting. The research questions were: 1) What is information appraisal within the clinical setting? and 2) How do nurses perform information appraisal in the clinical setting? Participants were assigned to one of seven audio-recorded focus groups of approximately five to seven participants. A semi-structured interview guide assisted in data collection. Participants completed a brief demographic survey. Transcripts from each focus group were coded inductively. Analysis was first done by looking at responses to each question within individual groups, then among groups. ATLAS.ti software was used to aid in data management. Findings suggest that information appraisal is described a number of ways by nurses and an agreed upon definition for the process seems to be lacking among nurses. Based on the descriptions offered by participants information appraisal contains three dimensions: information gathering, information analysis, and information application. In addition, nurses perform information appraisal by way of an unspoken algorithm with two major decision points. First, nurses determine the urgency of the situation. Next, they select the resource of choice based on prior knowledge of available resources, not the content provided by the resources. In most cases, the trusted resource served as a proxy for evaluating the information that was provided by the resource. Research with nurses in the clinical setting is challenging, however, much was gained from discussions with those that had firsthand knowledge of providing direct patient care. Understanding the perceptions of this sample has given insight into how nurses describe and perform information evaluation. Knowledge gained from this study may be used by nurse educators in the academic and clinical setting as they work to deliver relevant information that facilitates providing the highest quality care.

DOI

10.21007/etd.cghs.2011.0043

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