Day 1 - 2019 CNO Summit

1. Standardising best practice and supporting clinical decision
making for nurses
13th March 2019
Richard Hatchett
Senior Nurse Editor - RCNi
Decision Support

2. • RCNi is part of the Royal College of Nursing Group and an independent health care
information company for the whole nursing workforce
• Our profits are returned to the RCN for investment in the nursing profession in the UK and
worldwide
• Connecting with over 450,000 nurses, our mission is to inspire, develop and connect the
nursing community to deliver the best possible care
• We deliver a portfolio of nursing journals, education and support tools, careers services,
and thought leadership events
• We partner with organisations who are committed to our vision of improving the health of
patients and the public
Who are we?

3. Research &
Practice
•Nursing Standard
•Specialist Journals
•Resource Centres
•Hosted Content
•Daily alerts
Training &
Events
•Nurse Awards
•SJ Conferences
•RCNi Study Days
•Writing Workshops
•Bespoke Training
•Roundtables
Workforce
Learning &
Development
t
•RCNi Learning & Portfolio
•RCNi Decision Support
•Revalidation Workshops
•RCN Careers
•Jobs Fairs
Connect
Inspire
Develop
RCNi Product & Service Range 2019

4. • 2017 “Stingray” research examined access and use of
sources of information in practice by nurses – what helped
and hindered, and desires and wishes?
• Product development guided by the non-executive team
and the EABs, authors and reviewers
• Nurses wanted: easily accessible, digestible evidence-based
information
• Band 5’s tended to need more regular reassurance, others a
quick check
• Uncertainly over personal level of knowledge
• Use of various and possibly variable sources of information
Market research 2017 and through EABs /
reviewers

5. • There are a number of key studies and research in nurses’
clinical decision making
• Clinical decision making is a cognitive process influenced by
many (interactive) factors – knowledge base, prior
experience, intuition, confidence, time, the environment,
other colleagues present
• The characteristics that induce more rational and structured
decision-making included the presence of easily available
organising principles for collecting and handling information
• When time is limited, nurses describe severe restrictions in
accessing information beyond that which is readily available
• Therefore, time-limited situations separate day to day
decision making from information seeking and appraisal
What we know about clinical decision making

6. • The more complex the task is perceived to be and the
greater the number of information cues required to make a
decision – the more likely intuitive decision-making is
• The primary sources of information in two major studies
(Thompson et al, 2004), where the nurse was uncertain, was
human sources, such as the CNS.
• The analytical framework
• Intuition
• The cognitive framework
What we know about clinical decision making

7. • RCNi Decision Support is an interactive point-
of-care tool designed to help nurses make
evidence-based decisions when assessing
and treating patients
• It aims to enhance and support confident,
competent clinical decision making within
evidence-based frameworks
• The only decision support tool created
exclusively for nurses in the UK
What is RCNi Decision Support?
1/2

8. • It will provide nurses with fast and easy
access to a single trusted source of up-to-
date decision support and actionable best-
practice information to guide their critical
thinking and decision-making
• Includes over 100 peer-reviewed topics
which have been selected based on what will
have biggest impact on patient safety and
standard of care
What is RCNi Decision Support? 2/2

9. • Each topic highlights decisions that need to be made
at relevant points of assessment or treatment by
asking the nurse to answer questions based on patient
assessment and observations
• It then provides guidance on how to proceed based on
answers given by the nurse
• Includes red flags to ensure immediate action is taken
when needed
• The tool does not make the decisions for the nurse but
supports and guides them through the process and
provides them with the information they need, every
step of the way
How does RCNi Decision Support
work?

10. • RCNi Decision Support content draws on the latest
evidence-based research
• All the topics have been written by experts in various fields
of nursing
• Content has been subjected to an internal and double
blind-external peer-review process as per academic
articles
• The tool is always up to date to provide the nurse with the
latest guidance and policies
• Topics are continually reviewed and updated as soon as
guidelines change
Up to date evidence-based guidance

11. • RCNi Decision Support covers 23 specialties
• Wide applicability across the general workforce in both acute and community sectors
o Bowel & kidney o First aid o Infection
o Children o Pharmacology o Respiratory
o ICU o Wound care o IV therapy
o Diabetes o Safeguarding o Pain
o Mental health o Communication o Venous
o Resus o Medicines o Cardiac
o Nutrition o Midwifery o General
o Endocrine o Pre and post pregnancy
Content: Specialties

12. • Over 100 topics that focus on patient safety
and reducing common errors in practice
• Users can search by keyword or filter by
category
• Includes decisions to be made in:
 Hypo and hyperglycaemia
 Blocked urinary catheter
 Choice of IV line
 Oral and IV medicines calculations
 Exacerbation of COPD
 Medicines fridge failure
 Fever in young children
 NG tube placement
 Emergency contraception
 line inability to infuse
 Assessment and prevention of pressure ulcers
Content: Topics

13. Questions?