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Clinical decision making is complex
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Evidence-Based Decision Making
Evidence-based decision-making entails the process when a practitioner integrates the best research evidence in combination with clinical expertise and patient values to enhance the treatment outcomes. The three fundamental components of evidence-based decision-making include individual clinical expertise, scientific evidence and patient values and preferences (Peterson, Becker, Treasure, Shafran, & Bryant-Waugh, 2016). Scientific evidence entails the adoption of clinically relevant research conducted applying acceptable methodology. Clinical expertise is about the clinician’s cumulated education, skills, and experience in execution of the tasks. Patient values or preferences regard the concerns and expectations
Green (2005) identifies that, “Using evidence from reliable research, to inform healthcare decisions, has the potential to ensure best practice
Melnyk’s Hierarchy of Evidence is a system often use for assigning levels of evidence in nursing by integrates clinical expertise and patient choices with the best available research. It is represented by a pyramid that enumerates the levels of strength of the evidence from 1 to 7, of which level 1 is the higher level. The higher level on the pyramid, the more likelihood that the research is valid; therefore, answering a clinical or practice question. “The systematic review or meta-analysis of randomized controlled trials are at the top of the evidence pyramid and are typically assigned the highest level of evidence, due to the fact that the study design reduces the probability of bias” (Melnyk, 2011). The weakness of the system is that when
EBP is defined by Sacket et al as 'the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.' (Duncan, 2006) The best evidence in this context could therefore be argued to come from information that has been researched using quantitative methods that is numerical data that tests a hypothesis such as randomized control trials (RCT)(Duncan, 2006).
It is essential that when using evidence-based practice guidelines to choose a treatment, that variety of research methods are applied so that the best relevant data can be produced. Such methods include qualitative/quantitative research, randomised controlled trials and systematic reviews. Both qualitative and quantative methods produce valuable data. Quantative research produces numeric evidence that is necessary for practice and can be measured and qualitative research produces descriptive data about the subject by using patients views etc. which can also be applied to clinical practice (Broeder et al, 2010)
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
“At its 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”. Psychological Association (2006, p. 273) defines EBP as "the integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences. " When caring for patients it is fundamentally important to have a good selection of up to date evidence Based Practice clinical articles to support research strategies, this allows professionals to assemble the most recent and accurate information known which enables them to make decisions tailored to the individual’s plan of care. It is essential to have clinical expertise and have the involvement of the individual patient, they must have full engagement and incorporation in order to have the accurate evaluation.... ... middle of paper ...
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.
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.
...son (2005) evidence helps to build understanding of the ever-changing policy environment. It can assess the effects of policy change so that the most suitable options are chosen and their effects monitored. Evidence has the potential to link strategic direction with intended results and policy objectives. This can help to outline the necessary actions to achieve strategic goals. Evidence also helps influence others so that they contribute towards successful delivery of the policy (Shaxson, 2005).
In Dr. Spencer Johnson’s book, “Yes” or “No”; The Guide to Better Decisions, a young man embarks on a hike with a group of other people. During their journey, they learn to make better and more effective decisions using a system called the “Yes” or “No” system. This seemingly effective system focuses on the need to “focus on the real need” rather than focusing on one’s immediate desire. Dr. Johnson’s method via the anecdotes of the people in the story assist in creating better decisions by demonstrating how the decisions you make will affect you long term rather than the immediate gratification of choosing what seems to be right without any complex analysis of the outcome. This book helps one realize that you can make effective decisions, sooner
Despite our best intentions, it is hard to bring the best evidence to bear on our decisions (Kinicki, & Williams, 2012). However, recognizing failure to promote innovation has many benefits. Thus, recognizing disappointments to promote innovation is tricky. Nevertheless, the benefits of congratulating failure can have a positive approach on a team. Furthermore, there are seven implementation principles to help companies that are committed to doing what it takes to profit from evidence-based management (Kinicki, & Williams, 2012). Those are;
The key area of decision-making on direct patient care is intervention effectiveness, picking an intervention
Life is full of decisions. Some decisions are trivial. Should I choose paper or plastic at the grocery store? Which of the 31 flavors of ice cream should I pick? Other decisions are vital. Should I get married to her or should I take this new job? Your decisions may affect many people or only yourself. In this paper I will present a decision-making model. I will describe a decision that I made at work using this model and how critical thinking impacted that decision.
Making decisions is an important part of our everyday life. Decisions define actions and lead to the achievement of goals. However, these depend on the effectiveness of the decision-making process. An effective decision is free from biases, uncertainties, and is deeply dependent on information and critical thinking. Poor decisions lead to the inability to achieve set objectives and could lead to losses, if finance is a factor. Therefore, it is important to contemplate about quality and ways to achieve it in decision-making, which is the focus of this paper. The purpose is to look into the needs of decision-making, including what one should do and what one should not do.