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”. Green (2005) identifies that, “Using evidence from reliable research, to inform healthcare decisions, has the potential to ensure best practice …show more content…
The Cognitive Continuum Theory (Hammond 1988) is a descriptive theory that illustrates how judgement situations or tasks relate to cognition. The theory has six broad modes of decision-making based on two continua: cognition and judgement task structure (figure 1). This theory focuses exclusively on judgment and decision-making and ranges from intuition to analysis (Harbison, 2001). Judgment refers to the process of weighting or estimating the possibilities and a decision is defined as the outcome that leads to an action or a conclusion not to act (Cader et al, 2005). An analysis is defined as a process that is slow, conscious and consistent but has high cognitive control, slow data processing, high conscious awareness, task-specific organizing principle and high confidence in method (Hammond, 1988). Intuition involves rapid and unconscious data processing (Hammond,1988). Its properties are detailed by Hammond (1988) as involving low cognitive control, rapid data processing, low conscious awareness, averaging organizing principle and low confidence in the
By using the NMBA’s Nursing Practice Decision Making Framework, it enables the clinician who are making the referral decide whether or not the person they are referring Angela to are accountable, responsible, have authority and competent and/or require supervision to carry out a particular task (Nursing and Midwifery Board of Australia, 2013). A range of inter-professional team which are considered essential for Angela’s care include GP, psychologists, psychiatrists, registered nurses, and social workers (Department of Health, 2014). These members can be delegated as well as are the delegator different roles and responsibilities as they all provide different aspects of Angela’s care as they have different skills and knowledge (Davies & Fox-Young,
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.
A nurse’s role in decision making is minimal depending on the place of work residence. Authors Shoni Davis, Vivian Schrader, and Marcia J. Belcheir’s opinion on Ethical decision making in nursing is “a process that involves making an ethical consideration of a patient care situation” (738-749). It seems like nurses can just cite immediately or take a hunch of what is wrong with a patient, but doctors are the ones that actually do the direct diagnosing. There have been many decision making processes and theories. Each has its own unique concepts and terminology, but all have similar components. It identifies good nur...
Evidence - Based Nursing, An introduction (2008, p.1) “ At is core evidence based ‘anything’ is concerned with using valid and relevant information in decision making” “high quality research is the most important source of valid information”.
Since ethical dilemmas are not always easily answered through the use of The Code of Ethics, ethical decision-making models are effective tools that can assist nurses in dealing with ethical issues. Ethical decision-making models provide a framework for working through difficult choices. They seek to define the limits of what is morally acceptable and help clarify the guidelines for making those difficult decisions. Ethical decision making models assist nurses in analyzing situations by focusing on understanding the patient needs, need for responsiveness to circumstantial considerations, and recognizing the uniqueness of each situation.
In health care, evidence-based research is crucial. Nurses revolve their practice on evidence so that they may provide the best health care. Without research, there would be no evidence to prove health care related findings (Shmidt & Brown, 2012). With appropriate
Polly Beam, J. S. (n.d.). Levy Library. Evidence Based Medicine Tutorial. 1.3 What’s Best: The Evidence Hierarchy. Retrieved April 9, 2014, from http://libguides.mssm.edu/hierarchy
582). Ethical decision making is defined as “The process of choosing between actions based on a system of beliefs and values” (Black, 2014, p. 347). The nurse handling the ethical problem must first identify that there is in fact a problem. The second step is to acquire all of the required information related to the current situation. The third step is to come up with multiple choices and options to solve the ethical problem. The fourth step is to actually pick one of the choices utilizing sound ethical judgement. The fifth step would be to enact the made decision. The final step in the process is to reassess your decision and look for effectiveness and
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
Walshe,K. & Rundall,T. 2001, Evidence based management:From theory to practice in health care ,Milbank Quarterly, Vol.79, PP.429-457
Thus, it is imperative that evidence-based practice is conducted to provide the best current, valid and reliable evidence in an aim to close the gap between non-conformity and coincide with the professional obligation of providing the patient with the best possible care (Liamputtong, 2013).... ... middle of paper ... ... Patient safety and quality of care. Rockville, MD: Agency For Healthcare Research And Quality, U.S. Dept. of Health.
The Consensus on Evidence Based Practice The idea behind conforming to evidenced based practices is that research is the most likely tool to improve patient treatment outcomes. [2] Duly, care provider organizations are aligning policies and procedures with evidenced based practices to improve service quality. Public health advocates hope that this movement will standardize
Tunis S., Stryer D., Clancy C. Increasing the Value of Clinical Research for Decision Making in Clinical and Health Policy. JAMA. 2003;290(12): 1624-1632
Evidence-based medicine (EBM) has been described as “the conscientious, explicit, and judicious use of current best evidence in making decision about the care of individual patients” . Evidence-Based Practice is a thoughtful integration of the best available evidence, coupled with clinical expertise. It enables one to address healthcare questions with an evaluative and qualitative approach. It is about applying the best available research evidence in provision of health, behavior and education services to enhance outcomes. Evidence-Based practice is about performing the best possible practice in order to provide the best possible care .
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.