Outcomes based on decisions made from data that is gathered and documented by humans depends greatly on the accuracy of the data. Thompson (2003) states that the least reliable and valid form of evidence is the use of professional opinion without supplementary support or input. The article suggests and supports evidence based nursing practice for informed decision making via the use of clinical decision support systems. Androwich and Kraft describe a “push system” of clinical support where information is provided at the request of the clinician. These systems require current and expert information. If decision support systems are not based on current data based on valid and reliable studies, then decisions based on these systems will be outdated and inaccurate. Accuracy of patient diagnosis and recommended interventions suffers.
Nurses must also become proficient in summarizing, effectively phrasing, and capturing data in the appropriate location so that information can be retrieved for later use. This was been a problem at the Huntsman Cancer Hospital when a new computer charting system was implemented. In a “pull system” the clinician must enter data in order to initiate a request for information. Data that is entered inaccurately due to heuristics and biases generates information that cannot assist the patient as that patient has been represented inaccurately.
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You make several good points. Nurses must become proficient at capturing the data. Until we have the documentation, we will not be able to contribute to the vast knowledge base of evidence practice. Though many authors state that personal experience does not equate or equal hard evidence, it does have its place and much can be gained from those personal experiences. I also agree a lot of information is lost to biases and other heuristics. How many of us can really capture what happened through out the day at the end of the day? Essentially none of us can do this. We need to have systems in place to allow work to flow interrupted and still be able to capture the events. I have wished that I had a tape recorder or something to talk into to "chart" events, treatments, assessments, and such. The amount of data collected with the accuracy of real time would be phenomenal.
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