Decision Making in Clinical Practices
Introduction
Clinical decision making involves the gathering of information, awareness, experience, and use of proper assessment tools. The term is often used when describing the critical role of nurses. The process is, therefore, continuous, contextual, and evolving. Authentic practices and experienced people are required to offer guidelines when needed. Effective decision making in clinical environment combines skills such as pattern recognition, excellent communication skills, ability to share, and working as a team, reflection, use of the available evidence and guidelines as well as application of critical thinking. A Clear understanding of this term contributes to consistency, broadening of the scope and improving the skills. However, this paper aims at providing an opinion on clinical decision making and how it is connected to nursing practices.
The Nursing Process
This is a practice that provides a thinking framework through the provision of nursing skills to an organization. It is a useful, flexible tool in nursing practices that allows one to think and develop more creativity. Nursing process involves five phases in which when combined
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Making a clinical decision is a skill that needs to be acquired, and nurses are accountable for any decision that is made, so they need to understand how they make decisions (Nursing and Midwifery Council (NMC), 2015). A greater understanding of how nurses make decision is essential to follow research and development of decision making skills (Clark et al, 2009) . A first step to a decision making process may entail understanding a framework or model. Baumann and Deber (1986) define decision making as situations in which a choice is made among a number of possible alternatives often involving values given to different outcomes”.
There are several differences in competencies between an ADN and a BSN. These include, but are not limited to decision-making skills, the depth of knowledge base, as well as critical thinking abilities. As the nursing is role is becoming more complicated; strong skills are necessary for providing excellence in patient care (American Association of Colleges of Nursing, n.d.a., pp. 1,3). More than ever patients that are being admitted to hospitals have multiple commodities. When caring for a post-surgical open heart patient, it takes multiple types of critical thinking skills to recognize when a patient is becoming hemodynamically unstable. Quick, crucial, and significant decisions need to be made quickly to turn a grave situation around.
In conclusion, Mr. Devi journey discussed throughout the essay, focusing on the role of the nurse in clinical decision-making. This essay looks at the Tanner (2006) model that begins with gathering relevant information about the patient and assembling that information to identify the problems. To assess and comprehend his condition Mr. Devi physical, mental and social information gathered from a nursing perspective. Based on Mr. Devi background, current condition and assessment, his risk factors for stroke were identified. Further, in response to his problem a nursing care plan formulated in partnership with patient and nurse considering his values, customs and spiritual belief. Nursing interventions and actions were placed based on best available
I chose to go into nursing because I had taken a sports medicine class in high school I enjoyed, and I thought I would be guaranteed a job graduating that had something to do with medicine. I can remember being so excited to learn how about illnesses and medications, and all the difference procedures done in the hospital. At the time I thought a nurse’s job was to do what the physicians said, and I expected set guidelines that would tell me what I was and wasn’t allowed to do. I had no idea that I was entering onto a career path involving so much complexity, and that the skills I had dreamed of learning were such a small part of nursing in comparison to the emotional, decision making, and critical thinking skills that a nursing career requires. Ethics in nursing was not something that had ever crossed my mind when I chose to take this path, however now ethics is something that I think about every day I am practicing, whether in clinical or theory courses. Ethical theories often come from the idea that because we are human we have the obligation to care about other’s best interests (Kozier et al., 2010), however in nursing ethical practice is not just a personal choice but a professional responsibility.
This paper will discuss three theories of decision-making that can be adopted in nursing practice, additionally how decision-making theories are able to be implemented and used. Decision-making in nursing is adopted through the critical thinking process that provides each nurse a model to make the best choices, solve problems and to meet goals in clinical practice (Berman & Kozier 2018, pp. 199-200; Levett-Jones & Hoffman 2013, pp. 4-5). Effective decision-making in nursing is a vital component and part of the role of a registered nurse; each year a substantial number of patients die due to medical errors and poor decision-making (Levett-Jones & Hoffman 2013, pp. 4-5; Nibbelink & Brewer 2017, p. 3). Through the use of effective decision making
Pearson (2013) clarifies “clinical decision making is essential to every aspect of care delivered to a patient” (p. 214). It is the ability to blend information and make decisions that will later be implemented in the situation. Evidence-based decision making involves choosing from a variety of possibilities and combining the knowledge through research and the scientific evaluation of one’s practice. The purpose of this paper is to analyze my decision of administering ativan by advocating for the patient and anticipating her change prior to confirming signs; which provided a therapeutic response.
The nursing process is one of the most fundamental yet crucial aspects of the nursing profession. It guides patient care in a manner that creates an effective, safe, and health promoting process. The purpose and focus of this assessment paper is to detail the core aspects of the nursing process and creating nursing diagnoses for patients in a formal paper. The nursing process allows nurses to identify a patient’s health status, their current health problems, and also identify any potential health risks the patient may have. The nursing process is a broad assessment tool that can be applied to every patient but results in an individualized care plan tailored to the most important needs of the patient. The nurse can then implement this outcome oriented care plan and then evaluate and modify it to fit the patient’s progress (Taylor, C. R., Lillis, C., LeMone, P., & Lynn, P., 2011). The nursing process prioritizes care, creates safety checks so that essential assessments are not missing, and creates an organized routine, allowing nurses to be both efficient and responsible.
Lunney, M. (2010). Use of critical thinking in the diagnostic process. International Journal Of Nursing Terminologies & Classifications,21(2), 82-88. doi:10.1111/j.1744-618X.2010.01150.x
Clinical reasoning is the process that clinicians and nurses use to consider patient situation, collect cues, process information, then to make plans and implement interventions, finally to evaluate outcomes and reflect on learning from this process (Hoffman, 2007). The framework that is used in clinical reasoning is the clinical reasoning cycle. This case study will discuss, clinical care provided to Julie Kenny, a 27 year old female, admitted to emergency department after an exacerbation of asthma using the clinical reasoning cycle as a framework using objective and subjective data (Please refer to Appendix 1) that has been provided following a comprehensive nursing assessment. Asthma, a condition of the airways, is associated with hyper
Correct prediction of risk and risk stratification is an important goal to guide clinical in the decision making and patient outcomes. (Moonesinghe, Ramani et al.2013)
Looking back at my first year of being a physical therapist and comparing it to today, I can definitely say that my strategies for clinical decision-making have evolved. I can attribute it to my past experiences in the field and the wealth of knowledge that I gained from working with other members of the healthcare team as well as the numerous CE classes that I have attended in the past. When I first started with geriatric home care (after leaving the SNF setting), my initial evaluation would take forever to finish. It only made sense because everything was new - from the patient’s environment, the information needed to be gathered, and of course, the patients themselves. I was trying to get all available information to allow me to reach
Throughout this year we have explored many majors in class. After exploring the endless number of majors that are offered at UC. I have concluded that I want to major in nursing. Nursing has many requirements and specific abilities a person should possess. There are many positives of nursing and a few negatives. Overall it is a good fit for me and I am happy with my decision.
Decision-making is the process requiring critical thinking and forecasting ability to assist a person in selecting a logical choice from the available number of options. (Tiffen, Corbridge & Slimmer, 2014). Studies show that nurses make a health care decision every 30 seconds so it becomes an involuntary process for nurses to make clinical decisions. From admission itself, the plan regarding the patient’s bed occupancy, care and treatment will be decided. In geriatric nursing along with many other clinical care decisions nurse need to make decisions on long term care plan like selection of end of life care (EOL) and discharge planning.
Sampaio, C., & Guedes, M. (2012). Nursing process as a strategy in the development of
In the healthcare setting, a systematic process to ensure maximum care and maximum recovery in patients is needed, which is called the nursing process. This process consists of four steps: assessment, diagnosis, planning, implementation, and evaluation (Walton, 2016). The nursing process is important to ensure quality care and to get the preferred outcome. In the nursing process, critical thinking is used to recognize the issue and come up with a logical solution to solving it. One important aspect of the nursing process is that the plan is not set in stone; it is meant to be manipulated in order to better suit the patient. Nurses must be able to think critically in order to recognize the issue, develop a way to correct it, and be able to communicate the issue to others. Throughout the nursing process, critical thinking is used to determine the best plan of care for a patient based on their diagnosis.