At the end of this section, you will be able to:
‹ Describe strategies that individuals use to reduce uncertainty when making decisionsWeighing In on the Evidence
Carol O. Long
15.1 Deciding What to Do
Evidence-based nursing is the process whereby nurses make clinical decisions that integrate the best
available research with clinical relevance and incorporate the patient’s preferences, values, and circum-
stances (Melnyk & Fineout-Overholt, 2015). This assumes that sufficient evidence or research is clinically
relevant, methodologically sound, and of scientific merit (Straus, Glasziou, Richardson, & Haynes, 2011).
Some practice decisions are made by a committee responsible for overseeing policies and procedures
in the clinical setting. Other decisions can be made when circumstances warrant a timely decision. For
example, a patient may have an unusual complication that is not addressed by the current protocol.
Healthcare providers may collaborate after securing evidence about an innovative treatment, and, after
consulting with the patient, they may decide to implement it.
How do clinicians make decisions? There are really only two options: adoption or rejection of the in-
novation. Individuals aim to select the option about which they are the least uncertain. “Uncertainty is
the degree to which a number of alternatives are perceived with respect to the occurrence of an event and
the relative probability of these alternatives” (Rogers, 2003, p. 6). Individuals typically adopt an innovation
when uncertainty is reduced. When there is a significant amount of uncertainty about a new innovation,
individuals generally reject adopting the innovation.
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