Expert nurses' use of implicit memory in the care of patients with Alzheimer's disease.

AIM This paper reports a study exploring expert nurses' use of implicit memory in the care of people with Alzheimer's disease. BACKGROUND Although research has shown the benefits of preserving and using implicit memory in patients with Alzheimer's disease, the literature shows little evidence of how nurses, in particular expert ones, make use of implicit memory with this client group in clinical practice. METHOD Semi-structured interviews were carried out with a purposive sample of eight nurses (four from Michigan, United States of America and four from Northern Ireland) in 2004. The interviews focused on specific issues, but were deliberately flexible to allow participants to tell their stories as well. A nine-step data analysis process was developed based on a synthesis of methods used by other researchers. FINDINGS According to the expert nurses interviewed, the effective and meaningful use of the implicit memory of patients with Alzheimer's disease in achieving positive outcomes depended on 'knowing the patient', 'working within the patient's worldview' and 'using sensitive and patient-centred interactional skills'. They explained how their use of implicit memory (drawing from a range of knowledge sources) was underpinned by reflective practice. CONCLUSION The findings provide a positive profile of expert nurses' use of implicit memory of patients with Alzheimer's disease; however, their use of theoretical and research knowledge could be improved. There is also a need to test interventions based on the use of implicit memories.