Uncertainty and information need in nursing.

The assumption of practitioner uncertainty as a cause of practice variation has focussed attention on the information behaviour of health care professionals, but there is very little research into clinical groups other than doctors. This study considered the information needs of nurses and their attributions for uncertainty. The method was participant observation of three groups of nurse specialists from multiple health care providers who met over time to construct evidence-based consensus recommendations for practice. Practitioners were uncertain about the best course of action in half of the issues discussed. There were clearly expressed areas of information need, but the workgroup process uncovered more implicit uncertainty than was expressed. The recognition of problems in practice was central to the articulation of information need, rather than the existence of new solutions. Of the known areas of uncertainty, only those that were problematic and had a visible, practical solution were followed up. Factors contributing to uncertainty included a perception of lack of evidence, and differences in how problems were presented in practice and research. The occurrence of unrecognised uncertainty suggests that there are areas of clinical practice where helping to recognise and articulate information need may stimulate further interest in evidence-based practice.