Understanding nurses’ decision-making when managing weaning from mechanical ventilation: a study of novice and experienced critical care nurses in Scotland and Greece.

Aim and objectives To examine how nurses collect and use cues from respiratory assessment to inform their decisions as they wean patients from ventilatory support. Background Prompt and accurate identification of the patient's ability to sustain reduction of ventilatory support has the potential to increase the likelihood of successful weaning. Nurses' information processing during the weaning from mechanical ventilation has not been well-described. Design A descriptive ethnographic study exploring critical care nurses' decision-making processes when weaning mechanically ventilated patients from ventilatory support in the real setting. Methods Novice and expert Scottish and Greek nurses from two tertiary intensive care units were observed in real practice of weaning mechanical ventilation and were invited to participate in reflective interviews near the end of their shift. Data were analysed thematically using concept maps based on information processing theory. Ethics approval and informed consent were obtained. Results Scottish and Greek critical care nurses acquired patient-centred objective physiological and subjective information from respiratory assessment and previous knowledge of the patient, which they clustered around seven concepts descriptive of the patient's ability to wean. Less experienced nurses required more encounters of cues to attain the concepts with certainty. Subjective criteria were intuitively derived from previous knowledge of patients' responses to changes of ventilatory support. All nurses used focusing decision-making strategies to select and group cues in order to categorise information with certainty and reduce the mental strain of the decision task. Conclusions Nurses used patient-centred information to make a judgment about the patients' ability to wean. Decision-making strategies that involve categorisation of patient-centred information can be taught in bespoke educational programmes for mechanical ventilation and weaning. Relevance to clinical practice Advanced clinical reasoning skills and accurate detection of cues in respiratory assessment by critical care nurses will ensure optimum patient management in weaning mechanical ventilation

The role of networking and social media tools during job search: an information behaviour perspective.

The paper presents a critical analysis of the extant literature pertaining to the networking behaviours of young jobseekers in both offline and online environments. A framework derived from information behaviour theory is proposed as a basis for conducting further research in this area. Method. Relevant material for the review was sourced from key research domains such as library and information science, job search research, and organisational research. Analysis. Three key research themes emerged from the analysis of the literature: (1) social networks, and the use of informal channels of information during job search, (2) the role of networking behaviours in job search, and (3) the adoption of social media tools. Tom Wilson’s general model of information behaviour was also identified as a suitable framework to conduct further research. Results. Social networks have a crucial informational utility during the job search process. However, the processes whereby young jobseekers engage in networking behaviours, both offline and online, remain largely unexplored. Conclusion. Identification and analysis of the key research themes reveal opportunities to acquire further knowledge regarding the networking behaviours of young jobseekers. Wilson’s model can be used as a framework to provide a holistic understanding of the networking process, from an information behaviour perspective.