Use Of Research Findings Research Articles

Implementation of evidence-based practice: The experience of nurses and midwives.

BackgroundImplementation of evidence-based practice in clinical practice is crucial. Nurses and midwives play a vital role in using updated evidence. However, limited support and barriers to implementing evidence-based practice hamper the use of up-to-date evidence in clinical decision-making practice. Therefore, this study aimed to explore the implementation of evidence-based practice of nurses and midwives working in public hospitals.MethodsA qualitative descriptive study was conducted to explore the experience of implementing evidence-based practice among nurses and midwives working in public hospitals. A total of 86 participants, of which, 25 in-depth interviews, 5 FGDs having 47 participants and 14 participants were involved during observations, were considered in Amhara Region public hospitals from November 17, 2019 to April 25, 2020. The observational data, interview and FGD transcripts were imported into NVivo 12 plus to manage and analyze the data using the Computer-Assisted Data Analysis Software Program (CAQDAS). The data were analyzed through thematic content analysis.ResultsNurses and midwives perceived that implementation of evidence-based practice is the use of research findings, guidelines, hospital protocols, books, and expert experience in clinical decision-making practice. However, there was limited support for the implementation of evidence-based practice by nurses and midwives. The lack of knowledge and skill to use evidence like research findings, time mismanagement, the lack of motivation, the lack of resources and training were the perceived barriers to the implementation of evidence-based practice. Stick to the traditional practice due to lack of incentive and unclear job description between diploma and BSc nurses and midwives were the perceived causes of the lack of motivation.ConclusionsThe experience of evidence-based practice of nurses and midwives indicated that there was limited support for the implementation of evidence-based practice. However, research findings were rarely used in clinical decision-making practice The Knowledge, attitude towards implementing evidence-based practice, lack of resources and training, time mismanagement and lack of motivation were the barriers to the implementation of evidence-based practice. Therefore, the promotion of adopting the implementation of evidence-based practice and training on the identified barriers are mandatory.

A video analysis framework for the rugby league tackle

ABSTRACT Rugby league tackle video analysis research typically uses technical criteria from coaching cues or tackle variables from rugby union. As such, content validity and relevance could be questioned. A video analysis framework that establishes appropriate variables for rugby league is therefore required. The study aimed to adopt a 5-stage process to establish a video analysis framework for the rugby league tackle, which was content valid, relevant and reliable. The 5-stage process included 1) creation of draft video analysis framework, using available rugby tackle research, 2) expert group recruitment and critique, 3) refinement of framework to establish content validity, 4) response process validity task and agreement within expert group, 5) intra- and inter-reliability testing using Kappa statistics. The agreed framework comprised six phases including; tackle event, defensive start point, pre-contact, initial contact, post-contact and play-the-ball. Within the identified phases, 63 variables were established. The intra- and inter-reliability testing resulted in strong agreement within all phases. The video analysis framework can be used in rugby league tackle research, categorising complex tackle events, such as injurious or optimal tackles, improving both player welfare and performance. The application of the framework to future rugby league research will increase coherence and usefulness of research findings.

Factors Influencing Nurses' Involvements and Utilizations of Research Findings Among Nurses in a Teaching Hospital, South West, Nigeria

Background: Nursing is a profession that is concern with ensuring high quality of patient care. To providing quality care, participation in research and research utilization is very necessary. Objective: This study was designed to study factors influencing nurses’ involvement in research and utilization of research findings among nurses of a Teaching Hospital, South west, Nigeria. Method: A descriptive design was used. Convenient sample technique was used to select 198 Nurses and Self-developed questionnaire with reliability index of 0.875 was used for data collection. Data collected were analyzed using SPSS package. Descriptive and inferential statistics were used to test the hypotheses and results were presented in tables. Result: The outcome of the study showed that 153(77.3) have never carried out any research while70 (35.4%) have never make use of research findings. Factors such as time, organizational policy, mentorship, funds and knowledge of research are some of the major factors influencing the involvement of nurses in research while awareness of research findings, time to read research findings, support from colleague, unpublished research influenced utilization of research findings. There was a significant relationship between: support from colleagues and nurses’ utilization of research findings (p=0.001); between unpublished research and nurses’ utilization of research findings( p-value= 0.000); between time to implement new ideas and the utilization of research findings by nurses (p=0.005); between organizational support and nurses’ utilization of research findings (p= 0.001); between the presence of research committee and nurses’ utilization of research findings (p= 0.000). Conclusion; numerous factors highlighted above are noted to influence nurse’s participation and utilization of research findings; hence, a multidimensional approach should be applied in solving the problem.

Improving the Diagnosis, Treatment, and Prevention of Endocrine Diseases Through Accurate and Reliable Laboratory Measurements With CDC Clinical Standardization Programs

Laboratory measurements are critical for correct diagnosis and treatment of patients with chronic diseases such as hypogonadism, PCOS, and thyroid diseases. Inaccurate measurements of disease biomarkers can lead to misclassification of patients/incorrect treatment and prevent the effective use of research findings in patient care. The CDC Clinical Standardization Programs (CDC CSP) improve the accuracy and reliability of clinical biomarker measurements by assessing and improving the analytical performance of assays. The CDC CSP assist with assay calibration, the certification of analytical performance, and the monitoring of routine patient and research testing. The CDC CSP work with clinical/research laboratories and assay manufacturers to improve laboratory measurements. Its current programs include the following analytes: total testosterone (TT), estradiol (E2), vitamin D (VD), free thyroxine (FT4), total cholesterol (TC), total glycerides (TG), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C). The work is being conducted through certification/monitoring programs and technical assistance. Most assays participating in the certification programs have seen performance improvements and maintain performance over time by continuous participation. Most major commercial laboratories and assays manufactures are enrolled in the certification programs. Currently certified and non-certified assays are available. Assays certified by CDC CSP are listed on the website at https://www.cdc.gov/labstandards/hs.html. The CDC Lipid Standardization Programs and CDC Accuracy-based Monitoring Programs allow for weekly monitoring of analytical performance of routine tests for analytes including TT, VD, TC, TG, HDL-C, apolipoprotein A1 and B. These monitoring programs assist researchers with assessing measurement accuracy of research studies over time and across laboratories. The CDC CSP also support accuracy-based external quality assurance surveys such as those offered by the College of American Pathologists (CAP). The CDC CSP assist researchers and stakeholders with developing and establishing reference intervals and conducting studies to better assess and diagnose patients. Based on the needs and requests from clinical community, programs for new biomarkers such as Lp(a), PTH and glucose are being developed. The CDC CSP work with stakeholders, such as the Endocrine Society and the Partnership for the Accurate Testing of Hormones, to educate the clinical and laboratory communities about the importance of using standardized assays in patient care, research, and public health.

Introduction to special issue: clinical supervision in implementation science

ABSTRACT Implementation science is at the nexus of research and practice, and studies ways to promote the use of research findings in service settings. Clinical supervision has a rich theoretical literature for workplace support, and has also been used to ensure internal validity for “evidence based” interventions during efficacy trials. Calls to leverage supervision as an implementation strategy have prompted a focus on clinical supervision in implementation science. Articles included in this special issue address how supervision “typically” operates and how it might “optimally” promote implementation. A range of methodologies, client populations, settings, and mental health problem foci are included.

INCORPORATION OF RESEARCH FINDINGS IN HEALTH POLICY FORMULATION IN ZANZIBAR

This article through the guidance of evidence-based policymaking framework and the two communities’ theory on research utilisation qualitatively examines the interface between research findings and health policy formulation in Zanzibar. It specifically examines the application of research findings in the formulation of Zanzibar’s 2011-health policy, the linkage between policy makers and researchers in the formulation of the policy as well as the challenges that limited the use of research findings in the formulation of the policy. Data for the article were collected from 50 interviewees. The study found that the use of research findings in the formulation of the Zanzibar’s health policy was minimal and formal linkages between policy makers and researchers hardly existed to enhance evidence–based policy formulation. The limited interface between research findings and health policy formulation was attributed to lack of human and financial resources as well as commitment to establish institutions and institutional mechanisms required for furthering the same. As such, deliberate measures should be taken towards revitalisation of institutions for coordinating and furthering research within the Ministry of health and between the Ministry and researchers, increasing research and development resources and improving mobilisation of research findings and easing access of the same.

The Southampton system: a new universal standard approach for port-city classification

ABSTRACT The most widely-used current system for classifying port-cities is limited to container ports, excluding other types of cargo and passengers. This limits the usefulness of research findings and policy recommendations. A new system is proposed that includes passengers and all cargo types. In order to compare passenger numbers with cargo, the weight of ships from a sample of recent ship calls to Southampton was used to calculate the average cargo tonnage and passengers per tonne of ship. This led to the finding that 10 tonnes of cargo tonnage are equivalent to 1 passenger. This finding was validated with data from other ports and used as the basis for a new universal system (‘The Southampton System’), combining passenger numbers and cargo tonnage on one axis with urban population on another in a 4 × 4 matrix, creating 16 groupings of port-cities. The developed system was tested using data collected from 301 ports from around the world. These ports were successfully grouped, including ports that have not been included in previous systems due to a lack of containers. The Southampton System provides an effective and broader method for port-city classification, enabling more effective future study into, and policy recommendations for, port-cities.

111-OR: MODY3 Diagnosis from Deidentified Pancreatic Tissue Leads to Variant Identification in Living Relatives

As part of studies to understand human pancreatic islet pathophysiology in type 1 diabetes (T1D), we discovered normal β cell mass in a 33-year-old deceased organ donor with T1D for 17 years. Further analysis revealed the donor’s diabetes resulted from a causative variant in hepatic nuclear factor 1-alpha (HNF1A), associated with Maturity-onset Diabetes of the Young-3 (MODY3) (J Clin Invest 129:246, 2019), which can be treated with sulfonylureas. Review of the donor’s redacted medical chart suggested a family history of diabetes consistent with the known autosomal dominant pattern of inheritance of MODY3. With this clinically-actionable information, we desired to inform the donor’s family. However, de-identified samples are not considered “human subject” research by Institutional Review Boards (IRB), so the family’s identity was unknown with no defined pathway for communicating these findings. Working with a Human Tissue and Organ Research Resource and an organ procurement organization, we developed a new, IRB-approved communication path between those involved in tissue collection, scientific investigation, and the donor’s family and physician. This allowed targeted genetic testing of potentially affected family members, which revealed five living relatives of the donor who carried the HNF1A variant: three adults diagnosed with diabetes before the age of 25 currently treated with insulin and two children (ages 6 months and 3 years) who did not have clinical diabetes. Since none of the identified individuals were known to have MODY3, they will likely benefit from appropriate clinical care and surveillance. This experience demonstrates the need for the scientific community to develop guidelines to address handling, reporting, and use of research findings from de-identified tissue collected for research. Defining ethical avenues for donor family-investigator communications will benefit for both organ donor families and scientific research. Disclosure D. Sparling: None. R. Haliyur: None. J. Lindner: None. L. Weber: None. A. Ramirez: None. M. Brissova: None. A.C. Powers: None.

SAT-733 Improving the Diagnosis, Treatment, and Prevention of Endocrine Diseases Through Accurate and Reliable Laboratory Measurements with CDC’s Clinical Standardization Programs

Laboratory measurements are critical for the correct diagnosis and treatment of patients as well as in the investigation of chronic diseases such as hypogonadism, PCOS, and bone-and kidney-related diseases. Inaccurate measurements can lead to misclassification of patients and incorrect treatment. Furthermore, the effective use of research findings in patient care is prevented. The CDC Clinical Standardization Programs (CDC CSP) assess the analytical performance of assays against performance goals defined by clinical and medical organizations. The CDC CSP assist with assay calibration, the certification of analytical performance, and the monitoring of analytical performance during the measurement of patient and/or study samples. CDC CSP have programs in place for the calibration and certification of commercial assays and laboratory developed tests (LDTs) for total testosterone (TT), estradiol (E2), vitamin D (VD), free thyroxine (FT4), total cholesterol (TC), total glycerides (TG), HDL-cholesterol (HDL-C), and LDL-cholesterol (LDL-C). The programs available for monitoring analytical performance during routine testing include TT, VD, TC, TG, HDL-C, apolipoprotein AI and B. CDC CSP also support accuracy-based external quality assurance surveys such as those offered by the College of American Pathologists. Enrollment of assays and LDTs in CDC’s certification programs has resulted in improvements in calibration accuracy; i.e. the absolute mean bias of assays participating in the CDC Vitamin D Standardization Certification Program was well below the allowable bias of 5% each year. Assays standardized in CDC’s certification programs also demonstrated higher accuracy in routine patient testing; i.e. CDC VD certified assays have a lower bias compared to non-certified assays. Similar observations were made with assays certified in the CDC’s program for TT. Monitoring data over the past 10 years from the CDC Lipid Standardization Program indicated that the majority of TC measurements performed in routine testing were consistently within the recommended bias limits of ±3%. CDC CSP continue to improve the analytical performance of assays by addressing measurement bias caused by factors other than incorrect calibration such as interfering compounds. The programs are responding to new clinical and public health needs with the addition of new analytes such as PTH and glucose. The CDC CSP support projects aiming at establishing reference intervals and other research studies. The CDC CSP work with stakeholders, such as the Partnership for the Accurate Testing of Hormones and the Endocrine Society, to educate the clinical and laboratory communities about the importance of using standardized assays in patient care, research, and public health.

Seven lessons from the field: Research on transformation of health systems for older adults.

Research can play a key role in efforts to transform healthcare systems. Our group's long-standing research program has been aimed at understanding how to support greater integration and coordination of healthcare services for older adults with complex conditions. Drawing on this experience, we outline seven "lessons from the field" that highlight research-related challenges that may hinder health system transformation. These challenges relate to conducting research in a complex and constantly changing system; co-design approaches that are simultaneously deemed essential yet too ambiguous to fund; patient, family caregiver, and citizen engagement; limited funding for health systems research; and lack of use of research findings. We hope that these reflections will help to inform an ongoing conversation about how these challenges might be overcome.

What Does Evidence-Based Practice Mean to You? A Follow-Up Study Examining School-Based Speech-Language Pathologists' Perspectives on Evidence-Based Practice.

Purpose The current investigation is a follow-up from a previous study examining child language diagnostic decision making in school-based speech-language pathologists (SLPs). The purpose of this study was to examine the SLPs' perspectives regarding the use of evidence-based practice (EBP) in their clinical work. Method Semistructured phone interviews were conducted with 25 school-based SLPs who previously participated in an earlier study by Fulcher-Rood et al. 2018). SLPs were asked questions regarding their definition of EBP, the value of research evidence, contexts in which they implement scientific literature in clinical practice, and the barriers to implementing EBP. Results SLPs' definitions of EBP differed from current definitions, in that SLPs only included the use of research findings. SLPs seem to discuss EBP as it relates to treatment and not assessment. Reported barriers to EBP implementation were insufficient time, limited funding, and restrictions from their employment setting. SLPs found it difficult to translate research findings to clinical practice. SLPs implemented external research evidence when they did not have enough clinical expertise regarding a specific client or when they needed scientific evidence to support a strategy they used. Conclusions SLPs appear to use EBP for specific reasons and not for every clinical decision they make. In addition, SLPs rely on EBP for treatment decisions and not for assessment decisions. Educational systems potentially present other challenges that need to be considered for EBP implementation. Considerations for implementation science and the research-to-practice gap are discussed.

Marketing social marketing theory to practitioners

Social marketing (SM) literature stresses the importance of a strong theoretical foundation for successful communication and campaign building. SM theories accumulate massive amounts of evidence about human behaviour and how to change it, however, only a small percentage of SM campaigns advocating changes in behaviour such as quitting smoking, losing weight, and avoiding texting while driving currently rely on findings from previous research, theories or models. This indicates a need for more dynamic knowledge translation between academics and practitioners and more actionable guidelines for practitioners on how to find and use prior relevant research, theories and models, and make use of them in their work. We argue for the practicality and usefulness of theory at all the stages of SM campaign development. Our method relies on mapping past research, SM theory literature and practical illustrations onto the recommended components of the effective SM campaign. We explain why theory is important and discuss how the appropriate theory for a given SM context and audience can guide in setting communication and campaign objectives, segmentation and targeting, and Product, Price, Promotion, and Place strategies. Our analysis is followed by general recommendations for practitioners on how to make the best use of research findings, theories, and models. We also provide recommendations for researchers on how to make theoretical knowledge more accessible and promote dialogue with practitioners. Our goal is to encourage more SM initiatives grounded in research, theory, and models.

Communicating and disseminating research findings to study participants: Formative assessment of participant and researcher expectations and preferences.

Translating research findings into practice requires understanding how to meet communication and dissemination needs and preferences of intended audiences including past research participants (PSPs) who want, but seldom receive, information on research findings during or after participating in research studies. Most researchers want to let others, including PSP, know about their findings but lack knowledge about how to effectively communicate findings to a lay audience. We designed a two-phase, mixed methods pilot study to understand experiences, expectations, concerns, preferences, and capacities of researchers and PSP in two age groups (adolescents/young adults (AYA) or older adults) and to test communication prototypes for sharing, receiving, and using information on research study findings. PSP and researchers agreed that sharing study findings should happen and that doing so could improve participant recruitment and enrollment, use of research findings to improve health and health-care delivery, and build community support for research. Some differences and similarities in communication preferences and message format were identified between PSP groups, reinforcing the best practice of customizing communication channel and messaging. Researchers wanted specific training and/or time and resources to help them prepare messages in formats to meet PSP needs and preferences but were unaware of resources to help them do so. Our findings offer insight into how to engage both PSP and researchers in the design and use of strategies to share research findings and highlight the need to develop services and support for researchers as they aim to bridge this translational barrier.

Typologizing Stakeholder Information Use to Better Understand the Impacts of Collaborative Climate Science.

There is increasing interest among scholars in producing information that is useful and usable to land and natural resource managers in a changing climate. This interest has prompted transitions from scientist- to stakeholder-driven or collaborative approaches to climate science. A common indicator of successful collaboration is whether stakeholders use the information resulting from the projects in which they are engaged. However, detailed examples of how stakeholders use climate information are relatively scarce in the literature, leading to a challenge in understanding what researchers can and should expect and plan for in terms of stakeholder use of research findings. Drawing on theoretical, typological, and evaluation insights from the field of information use, we examine stakeholder use of climate information emerging from 13 collaborative climate science projects conducted in the western United States between 2012 and 2016. Three primary types of use emerge from our findings-conceptual, instrumental, and justification-reflecting common typologization of information use. Conceptual use was the most predominant. We suggest that researcher awareness of this typology can enable more systematic understanding of what project outputs stakeholders use and impacts of those outputs, giving way to new areas of inquiry and aiding in the conceptualization and design of climate information products for land and natural resource managers.

Nurse’s Perception of Barriers to Research Utilization in Hospitals; Comparative Descriptive Study

Background: Although the number of studies on research utilization is steadily growing, but still there is a strong need to identify the main causes that inhibit the use of research findings in the clinical setting. Aim of the Study: To assess nurse’s perception of barriers to research utilization in Saudi Arabia and Palestine Hospitals. This study focuses on medical and surgical nurses in private hospitals. Method: A convenient sample of 156 medical nurses, from 6 general private hospitals, 3 from north Palestine and 3 from Riyadh City (KSA). Results: Out of 180 nurses employed from private hospitals, a total of 156 questionnaires were returned (response rate 86.67%). Results in a final sample size for analysis of 156. The demographic characteristics, age, gender, hospital, role on health care team, clinical experience, marital status, education degree, and current certified in a special area of respondents are shown in Table 1. Their mean age was 29.41, about half of them below 6-year clinical experience 77 (49.4%). Although around 90 (57.7%) of the participants from Palestine hospitals and 66 (42.3%) from Saudi Arabia hospitals, almost half of them their education (diploma) 85 (54.5%). In addition, 114 (73.1%) were female, 85 (54.5%) have current certified in a special area, and 140 (89.7%) respondents worked as staff nurses. Regarding perceptions of barriers to research utilization, the results of the barriers show in the total scale a mean of 3.15 out of 5 f (SD = 0.55; 95% CI 3.05 to 3.23). The subscales of setting and research were the highest one (mean = 3.22, SD = (0.63), and the lowest one is “nurse” (mean = 2.95, SD = 0.75). Conclusions: The main barriers of research utilization in practice for nurse are nurses themselves, the setting in the hospitals and research in its process and findings.

Knowledge Translation Status in Shiraz University of Medical Sciences

Background: The optimal use of research findings is crucial. One of the activities that improves application of research-derived knowledge is the knowledge translation. This study aimed to investigate the status of knowledge translation in Shiraz University of Medical Sciences. Methods: This cross-sectional and descriptive-analytical study was conducted in 2018. The sample size included 143 faculty members of Shiraz University of Medical Sciences selected using the stratified sampling and simple random sampling methods. The required data were collected using a standard knowledge translation questionnaire consisting of 50 items in 4 dimensions. The validity and reliability of the questionnaires were confirmed in the previous studies. The collected data were analyzed using SPSS 21 by descriptive and analytical statistics. Results: The results showed that overall status of the knowledge translation was weak (2.46 ± 0.67). In this regard, producing useful evidence for decision making (2.77 ± 0.77) and promoting application of evidence (2.33 ± 0.88) had the highest and lowest mean scores, respectively. Furthermore, the overall mean of knowledge translation was significantly different with gender, type of center, and scientific rank (P < 0.05). Conclusion: Given the undesirable and weak status of knowledge translation, creating a culture of knowledge translation, training about knowledge transfer and utilization of research findings, creating incentive mechanisms, developing transparent processes and guidelines, and strengthening the interaction between knowledge producers and research users are essential.

The Importance of Community Engagement and Research Translation within the NIEHS Superfund Research Program.

The National Institute of Environmental Health Sciences Superfund Research Program (SRP) funds university-based, solution-oriented research to understand how hazardous substances contribute to disease and how to prevent exposures to these hazardous substances. A unique aspect of the SRP is that, beyond the biomedical, environmental sciences, and engineering research projects, SRP-funded centers are required to include community engagement to build partnerships with affected communities and research translation to communicate and facilitate the use of research findings. The SRP views both as effective ways to inform and advance science for protection of public health. The purpose of community engagement within the centers is to ensure bidirectional communication between the researchers and the community, identify best practices and activities in community engagement for prevention and intervention activities, enhance knowledge, and support the needs of the communities impacted by hazardous waste sites. The SRP views research translation as communicating and facilitating the use of research findings emanating from the center in a manner most appropriate for their application and for the advancement of a center’s research objectives. The SRP has a strong history of seeking opportunities to work with communities and stakeholders, by translating and sharing research findings in an impactful and informative manner with long-lasting benefits to improve public health.

Awareness about and Implementation of Research Findings on Mathematics Education among Teachers in Selected Schools in Ibadan, Nigeria

This study attempted to establish the level of awareness about and implementation of research findings in some aspects of Mathematics Education. Two validated instruments (on teachers’ awareness about and their use of research findings) were used to collect data from 132 mathematics teachers who had been purposively selected from a random sample of 34 secondary schools in Ibadan metropolis. The findings were that Mathematics teachers are moderately aware of research findings on Mathematics education. There were significant differences between teachers’ qualifications in Mathematics and use of research findings on Mathematics testing. Motivation of Mathematics teachers to explore new strategies of teaching and to implement them in their classroom practice is recommended .

Physicians' and Nurses' Perspectives on the Decision to Perform Lumbar Punctures on Febrile Infants ≤8 Weeks Old.

There is wide variation in the decision of whether to perform lumbar punctures (LPs) on well-appearing febrile infants ≤8 weeks old. Our objectives were to identify factors that influence that decision and the barriers and facilitators to shared decision-making about LP with parents of febrile infants. We conducted semistructured interviews with 15 pediatric and general emergency medicine physicians and 8 pediatric emergency medicine nurses at an urban, academic medical center. Through interviews, we assessed physicians' practices and physicians' and nurses' perspectives about communication and decision-making with parents of febrile infants. Two researchers independently reviewed the transcripts, coded the data using the constant comparative method, and identified themes. Five themes emerged for factors that influence physicians' decisions about whether to perform an LP: (1) the age of the infant; (2) the physician's clinical experience; (3) the physician's use of research findings; (4) the physician's values, particularly risk aversion; and (5) the role of the primary care pediatrician. Barriers and facilitators to shared decision-making identified by physicians and by nurses included factors related to their perceptions of parents' understanding and acceptance of risks, parents' emotions, physicians' assessment of whether there is clinical equipoise, and availability of follow-up with the primary care pediatrician. Differences in physicians' values, use of research findings, and clinical experience likely contribute to decisions of whether to perform an LP on well-appearing febrile infants. Incorporation of parents' preferences through shared decision-making may be indicated, although there are barriers that would need to be overcome.

The Illusion of Consensus: Febrile Neonates and Lumbar Puncture.

In the current issue of Hospital Pediatrics , Aronson et al1 conducted a qualitative analysis of factors influencing decision-making on lumbar punctures (LPs) in febrile infants ≤8 weeks of age. In this study, they interviewed 15 physicians and 8 nurses, identifying 5 main factors that influence the decision about whether to perform an LP: age, physician experience, use of research findings, physician values, and the role of the primary care provider. The authors also explored the role of shared decision-making, identifying both facilitators and barriers to incorporating a family into the decision on whether to perform an LP. Within their study sample, Aronson et al1 report physicians stated that they uniformly perform LPs for all infants ≤4 weeks of age, identifying consensus as the driving and primary factor influencing the decision for performing the procedure. Consensus, defined as …