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Table 5 Effect of nurse attitudes to risk on proportion of calls sent to self care: odds ratios* based on 211 nurses making 231,112 calls, with numbers of nurses in each category in brackets

From: The effect of attitude to risk on decisions made by nurses using computerised decision support software in telephone clinical assessment: an observational study

Items groups by original concepts of risk Strongly agree Agree Neither Disagree Strongly Disagree p-value
Risk tolerance in clinical decision-making       
1. When in doubt it is preferable to refer to a service than to wait and see 1 (22) 1.05 (102) 1.00 (40) 0.86 (44) - (1) 0.001
2. An NHS 24 nurse must prefer the certain to the uncertain 1 (16) 1.39 (73) 1.22 (55) 1.36 (53) 1.24 (5) 0.001
3. An NHS 24 nurse must not take any risks with physical illness 1 (58) 0.67 (97) 0.95 (21) 1.02 (32) - (0) 0.06
4. For physical complaints an NHS 24 nurse should do everything possible to establish the cause of a complaint 1 (34) 1.01 (97) 0.63 (23) 1.32 (48) 1.05 (4) 0.002
5. As an NHS 24 nurse you must always be aware that each complaint might be the beginning of a serious illness 1 (31) 0.92 (108) 0.42 (30) 0.81 (37) 1.62 (4) 0.09
Competing expertise of nurse and computer       
6. I prefer to use a clinical algorithm than to assess calls on my own 1 (13) 1.09 (52) 1.26 (53) 1.69 (81) 1.20 (10) 0.001
7. It is best to avoid overriding clinical algorithms unless absolutely necessary 1 (4) 0.95 (41) 0.99 (35) 1.47 (112) 1.36 (17) 0.001
8. The most important thing is to follow the agreed algorithms - (0) 1 (15) 0.84 (48) 1.05 (119) 0.97 (27) 0.20
9. I often feel I know better than the clinical assessment system 1 (7) 1.01 (46) 0.96 (89) 0.91 (57) 0.83 (7) 0.002
10. Intuition or gut reaction plays an important role in my clinical decision making 1 (32) 1.09 (132) 0.72 (29) 0.92 (18) 1.00 (2) 0.001
11. I have strong views on where particular patients should be advised to go 1 (11) 1.53 (83) 1.13 (80) 1.41 (34) 1.38 (2) 0.001
Competing risks between missing illnesses and overloading services       
12. It is important not to overload busy services 1 (53) 1.00 (101) 1.01 (29) 0.98 (24) 1.28 (1) 1.00
13. To be safe, it is better to send 100 patients to a service unnecessarily than to leave one at home who needs care 1 (4) 0.59 (26) 0.52 (37) 0.61 (118) 0.60 (24) 0.11
14. I feel that nurses in NHS 24 tend to send more patients to services than is really necessary 1 (9) 1.36 (66) 0.93 (55) 1.33 (72) 0.99 (7) 0.005
General       
15. I tend to be quite a cautious person 1 (14) 1.38 (88) 1.48 (63) 1.32 (41) - (1) 0.001
  1. *adjusted for age and sex of patient and time of call