Decision‐making in acute care nursing requires an evaluation of many complex factors. According to Waterlow (1985), recommended care interventions are available with each recommendation corresponding to the risk score parameters of the Waterlow scale. Link the clinical decision making case study to the National competency standards for the registered nurse if … Decision‐making in acute care nursing requires an evaluation of many complex factors. If you need assistance with writing your essay, our professional essay writing service is here to help! … For example, if a patient scores 15 or over on the Waterlow scale, the individual may be considered at risk of developing pressure sores and therefore the nurses will have to maintain a pressure ulcer prevention (PUP) bundle in order to keep track of the patient’s condition. Science and Intuition: Do both have a Place in Clinical Decision Making? Download file to see previous pages It can be stated that decision making is one of the chief elements of the nursing work which is quite significant to comprehend since organisations discover cost effective ways for the purpose of delivering quality healthcare (Boblin-Cummings & Et. Pearsosn, H. (2013). Alternatively, Paediatric Early Warning Scores (PEWS) is use for children, to record observations and is use to assess the child’s condition i.e. EWS were developed to assist health care professionals detect if patients are deteriorating. There are four stages that pressure ulcers are graded at and it is down to the nurses own clinical judgement to decide what stage the ulcer is. The use of early warning score (EWS) is the best practice for clinical observations (Department of Health, 2000), and this is backed up by NCEPOD (2005) who emphasised that every in-patient should have a EWS recorded. Each decision making model requires certain set of skills in order to be put on proper use and get the right results. For example, nurses must deliver care based on the best available evidence or practice and must ensure any advice given to patients are evidence based. This paper "Clinical Decision Making in Nursing" focuses on the fact that recent policy changes and trends in professional development in the health care system have entrusted nurses with greater responsibilities in patient care. Then an example of method use will be discussed. There are factors to be considered before selecting a mattress for the patient which include, making sure the mattress does not elevate the patient to an unsafe height and to ensure the patient is within the recommended weight range for the mattress NICE (2005). Company Registration No: 4964706. Clinical reasoning and decision-making is the fourth concept of the Practice Competence and Excellence (PCE) dimension and the second of the four PCE concepts that form the Careful Nursing critical circle of clinical responsibility. We're here to answer any questions you have about our services. The decisions they make have an impact on health care outcomes. Clinical Decision making and the Nursing Process Sample Essay Discuss the ways in which the nursing process contributes to effective clinical decision-making The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse’s personal qualities as well as upon the setting of the assessment. Begin by considering your clinical decision-making in your nursing It recognises that health care is individualised and ever changing and involves uncertainties and probabilities. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. The post Clinical Decision Making first appeared on Submit Your Essays. The decision making process begins with the identification of a problem and ends with the evaluation of choices and taking a course of action (Bernhard & Walsh, 1990) with nurses actively using decision making in various situations from planning patient care to prioritising their work load (Finklemann, 2006). Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. One of the tools used in evidence based practice is the use of the early warning score system (EWS). It allows the nurse to provide high quality care to patients based on knowledge and research Rodgers (1994). It only takes one nurse to lack competence when using the EWS, therefore putting patient’s life’s at risk. According to Guy, H. (2007), risk assessment on pressure ulcer requires multifactorial consideration. Disclaimer: This work has been submitted by a university student. Nurses should always be aware of any potential risk factors that may worsen or add to the development of pressure ulcers when using any pressure risk assessment tool. Early Warning Score (EWS) is an evidence based method. There are many different types of risk assessment tools available for patients and staff within the clinical setting. Evidence Based Practice Essay. Nurses have to make important clinical decisions in their everyday practice. Staff have Infection Control Assessments and Discharge Risk Assessments only to name a couple but they should be kept up to date and reassessed regularly Daniels (2004). and where decisions were made to improve The Nursing and Midwifery Council (NMC, 2008) states that nurses are personally accountable for their actions during practice and therefore they must be able to justify their decisions at all time. VAT Registration No: 842417633. To prepare: Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. The development of a comprehensive and individualised care plan will relate to the broad range of effective treatment, rehabilitation and support services provided at the current level of clinical knowledge (Morgan, S., 1998). Nurses should adapt to following guidelines the Early Warning Score offers, to help make clinical decisions that are best for their patients. Describing clinical decision-making In this activity you will describe a clinical decision-making scenario from your practice. Pearsosn, H. (2013). It helps us to identify the ethical issues and evaluate the values of identified issues (Kerridge, Lowe & Stewart 2009, p.92). There is a rich heritage of research into decision making and judgement, both from within the discipline of nursing and from other perspectives, but which focus on nurses. As nurses, we use different information sources to support our judgement and decision making. T.J is newly born with a lack of cerebral cortex. A key factor that may hinder accurate PEWS scoring could be due to the fact the child is scared when it comes to checking their vital signs, also very young children can be unwilling or fidgety Kyle (2008), this is where the nurse would have to use their knowledge to overcome such problems. Sackett el al (1996) defines evidence base practice as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient by incorporating individual clinical expertise with the best available external clinical evidence from a systematic research.” This means that one solution will not be the same for all clinical scenarios and it is the nurse’s role to identify the research that best fits the clinical situation. A number of research papers, in recent times, have thus mentioned that leadership in nursing is also a crucial part for the reason that nurses are now considered as the single largest healthcare discipline (Cope and Murray, 2017; Cummings et al., 2018). Clinical Decision making and the Nursing Process Sample Essay Discuss the ways in which the nursing process contributes to effective clinical decision-making The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse's personal qualities as well as upon the setting of the assessment. Discussion Question: Describe the value of qualitative research in healthcare and its’ impact on clinical decision making. It is the foundation on which decisions are made and risks plans are then formulated through available national and local policies and procedures (Morgan, S.,1998). This essay may contain factual inaccuracies or out of date material. The nurse could make it fun for the child, explain the equipment and what they are going to do and why. The pressure ulcer risk assessment/prevention policy tool, is frequently used in clinical practice. This concept is intertwined with and follows directly from the concept of watching-assessment-recognition. The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). A number of research papers, in recent times, have thus mentioned that leadership in nursing is also a crucial part for the reason that nurses are now considered as the single largest healthcare discipline (Cope and Murray, 2017; Cummings et al., 2018). According to Lipsedge (1995), good practice in risk assessment requires nurses to translate their knowledge into a clearly distinct formulation of the risks. Control over practice: The authority, freedom, and discretion of nurses to make decisions related to the practice setting, such as the organizational structure, governance, rules, policies, and operations Skår (2009) studied the meaning of nurses’ experiences of autonomy in practice and found knowledge and confidence were the two major r… Describe a clinical situation where you were concerned (e.g., a higher incidence of falls, infections, errors, etc.) Abstract—Clinical judgment and decision-making is a required component of professional nursing. The nursing process of assessment, diagnosis, planning, implementation, and evaluation are dependant upon both the nurse’s personal qualities as well as upon the setting of the assessment. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. Study for free with our range of university lectures! Use of this feed is for personal non-commercial use only. This involves moving the patient into a different position to remove or redistribute pressure from a part of the body Walsh and Dempsey (2010). Learning about developing and applying effective clinical decision making skills is vital for the wellbeing of patients and nurses’ capacity to demonstrate that decisions are justified. • Define the decision – Decision-making can only occur when there is a choice between actual alternatives. M. (1996). But just like the nursing process, it is important to remember that the decision-making process is dynamic and cyclical. ©2019 "Submit Your Assignment". evaluate the use of assessment tools in current practice. Clinical-Decision Making In The State of Georgia, why is it good for large companies to have the four exceptions (the Standard Exception classifications, the Interchange of Labor rules, the General Exclusion classes, and the We've received widespread press coverage since 2003, Your UKEssays purchase is secure and we're rated 4.4/5 on reviews.co.uk. NICE Clinical Guideline 50 (2007) suggests that physiological track and trigger systems should be implemented to monitor all adult patients in acute hospital settings, providing guidance on the standardization of EWS. Gurbutt, R. (2006). Evidence-based practice (EBP) is one reliable process that assists in efficient clinical decision-making (Wong & Myers, 2015). Not only is risk analysis for the patients safety but it’s also there to ensure staff safety Kavaler and Spiegel (2003). ©2019 "Submit Your Assignment". The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). If you need assistance with writing your essay, our professional essay writing service is here to help! I have been made aware of potential risk factors that may arise while using both tools in all fields of nursing and what could be done to prevent them. The ability to carry out competent decision-making is a critical and fundamental aspect of professional nursing. Orme and Maggs (1993) identified that decision-making is an essential and integral aspect of clinical practice. Clinical Decision-Making Essay Assignment. Nurses are accountable for their decisions, therefore it is crucial that they are aware of how they make these decisions Muir (2004). Clinical Decision-Making Essay Assignment. Evidence based practice values, enhances and builds on clinical expertise, knowledge of disease mechanisms, and pathophysiology. We've received widespread press coverage since 2003, Your UKEssays purchase is secure and we're rated 4.4/5 on reviews.co.uk. Clinical Decision making and the Nursing Process Sample Essay. Clinical Decision Making Tools essay was first posted on December 7, 2020 at 9:48 pm. Evidence-based decision making involves choosing from a variety of possibilities and combining the knowledge through … This review indicates that naturalistic decision making may be applicable to decision‐making nursing research. No risk assessment tool can be 100% accurate. If you are not reading this article in your feed reader, then the site is guilty of copyright infringement. We are accountable to the patients, clients and service users to whom we owe a duty of care. What does evaluate mean in an essay question Essay on digital india for aatmanirbhar bharat opportunities on covid 19 and beyond in english what are the essay formats . The key issue in examining risk assessment tools is how good they are at distinguishing those at risk from those who are not and if they are better or more accurate than simply relying on professional judgement (Thompson, C. & Dowding, D., 2002). This essay will discuss two decision making models, factors that may improve or interfere with clinical reasoning and decision making in patient centred care and how they vary across the different fields of nursing. Decision making requires thinking skills to exercise judgement in assessing the benefits of available options and choosing a preferred option that is then acted upon. Using their learnt skills, experiences and own clinical knowledge, nurses have to decide what dressings should be used in the treatment of pressure ulcers. A nurse may assess a patient as at risk of developing pressure sores, and then implement measures to try and reduced the likelihood of this event occurring by providing equipment such as specialist mattress. the patient’s heart rate, respiratory rate, temperature, oxygen saturations and systolic blood pressure. It requires nurses to have a high level of critical thinking. Evidence refers to information that is used to support particular beliefs, decisions and actions. The nurse will have to decide the frequency of re-positioning the patient, implementing a turning chart to keep times and dates documented and to communicate to other members of staff what time the patient needs turning. Clinical autonomy: The authority, freedom, and discretion of nurses to make judgments about patient care 2. Simple decisions such as, would a bed pan or commode be more appropriate? Looking for a flexible role? Nurses are expected to use valid evidence to support their decisions when deciding what care to provide each patient. Free resources to assist you with your university studies! Also, studies by McGuinty and Anderson (2008) and Williams (2004) showed that evidence based practice has reduced healthcare costs and geographic variation in delivery of care. To making quick, on the spot decisions, such as what steps to take if a patient began to rapidly deteriorate. CONCLUSIONS: A more comprehensive understanding of nurses' uncertainty could lead to the development and implementation of strategies to support nurses in their clinical decision-making and practice. [u.a. I have learnt various things while researching into the chosen decision making models and methods. Introduction It is fundamentally important for nurses to develop and appreciate the process of integrating evidence and research conclusions into their clinical decision-making. This essay will discuss two decision making models, factors that may improve or interfere with clinical reasoning and decision making in patient centred care and how they vary across the different fields of nursing. Most nurses are familiar with the use of pressure sore risk assessment tools such as the Braden or Waterlow scales. There are number of clinical reasoning and decision making models used in nursing practice, however this essay will discuss evidence based-practice and the ethical/legal models. Reduction, it is not appropriate to be the first step in the provision of holistic care taking account pertinent... High quality care to provide the best possible care for their patients and this involves using evidence-based practice EBP. Of identifying and investigating factors associated with the patterns of circumstances in which factors... Explore the understanding of decision-making theories and their effectiveness associated with the patterns of circumstances which! 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