Nursing 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. Nurses' clinical decision making. The Waterlow scale is mostly used in adult field of nursing. If the EWS tool is not used as it should be in these fields then it will be hard for the health care professionals to obtain the needed evidence to make accurate clinical decisions. *You can also browse our support articles here >. Oxford: Radcliffe. (Quan, 2006) For example, during the assessment, increased knowledge on the part of the nurse practitioner leads to greater clinical … Reference this. Making the wrong clinical decision is not only harmful to patients but can also damage a nurse’s career. 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. the patient’s heart rate, respiratory rate, temperature, oxygen saturations and systolic blood pressure. Clinical decision making: From theory to practice; a collection of essays from the Journal of the American Medical Association. It only takes one nurse to lack competence when using the EWS, therefore putting patient’s life’s at risk. 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… Simple decisions such as, would a bed pan or commode be more appropriate? EBP enables the nurse to make decisions about patient care based on the most current, best available evidence. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. Becoming skilled in clinical decision making requires the application of a range of evidence regarding patient concern, physical and human resources within healthcare contexts, understanding health and illnesses, developing expertise in applying therapeutic approaches, a commitment to enhance the wellbeing of those in your care and fulfilling the requirements of the relevant professional body. 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). You can buy this book. Assessment is considered to be the first step in the process of individualised nursing care Neno and Price (2008). *You can also browse our support articles here >. Identify the stages of the Nursing Process and the skills essential to the Nursing Process. Different leadership theories support the practice of leadership and suggest that senior nurses embrace leadership capabilit… Kerridge's ethical decision making model provides 7 steps systematic approach. It recognises that health care is individualised and ever changing and involves uncertainties and probabilities. 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. Nurses' clinical decision making. If you need assistance with writing your essay, our professional essay writing service is here to help! Nurses have to make important clinical decisions in their everyday practice. Clinical Decision Making Tools essay was first posted on December 7, 2020 at 9:48 pm. It involves complex and conscientious decision making based not only on the available evidence but also on patient characteristics, situations and preferences. Company Registration No: 4964706. Clinical Decision-Making Essay Assignment. 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). Accurate and timely observations and adherence to EWS is essential in order to recognise patients who are at risk of deterioration. Are developing appropriate critical thinking, clinical reasoning and sound clinical decision making processes and strategies essential for safe, evidence-based and competent nursing practice in medical/surgical settings. 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. 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. Firstly, two decision-making theories that are useful in making clinical decisions will be discussed. M. (1996). 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. Decision-Making Process The decision-making process is often broken down into a series of linear steps. 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. Carberry (2002) identifies that the purpose of EWS is to provide nursing and medical staff with a physiological score generated from recordings of vital signs. Most nurses are familiar with the use of pressure sore risk assessment tools such as the Braden or Waterlow scales. “Integrating research evidence into decision making involves forming a focused clinical question in response to a recognised information need, searching for the most appropriate evidence to meet that need, critically appraising the retrieved evidence, incorporating the evidence into a strategy for action, and evaluating the effects of any decisions and actions taken.” – Thompson et al (2004). If health care professionals are well able and confident in recording and documenting patient’s vital signs, then any changes can be observed and prevented or dealt with quickly. They have to take into consideration the grade of the sore, any manufacturer’s indications for use and contraindications, previous positive effects of certain dressing and preference for comfort or lifestyle reasons Bouza et al (2005). This review indicates that naturalistic decision making may be applicable to decision‐making nursing research. We're here to answer any questions you have about our services. Copyright © 2003 - 2020 - UKEssays is a trading name of All Answers Ltd, a company registered in England and Wales. Please refer to an authoritative source if you require up-to-date information on any health or medical issue. All nurses use clinical judgement to make decisions while caring for patients. No plagiarism, guaranteed! It is important that the family play an important role in the care of the child DOH (2001). Looking for a flexible role? Gurbutt, R. (2006). It is the ability to blend information and make decisions that will later be implemented in the situation. … It is the nurse’s duty to provide the best possible care for their patients and this involves using Evidence-based practice. No risk assessment tool can be 100% accurate. EWS were developed to assist health care professionals detect if patients are deteriorating. ©2019 "Submit Your Assignment". 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. Sometimes it is difficult for the nurse to come to a decision that will satisfy clients and co-workers and they also may be challenged at any time, however the important thing is that the nurse takes full responsibility and is able to justify his/her decision. Decision-Making Process The decision-making process is often broken down into a series of linear steps. This concept is intertwined with and follows directly from the concept of watching-assessment-recognition. According to Guy, H. (2007), risk assessment on pressure ulcer requires multifactorial consideration. Indications of these effects may be noticed in their EWS, combined with the knowledge and clinical judgement of health care professionals NIMH (2008) . Free algebra homework help Of expt aeration of decision on nursing essays clinical making growth medium growtha 24 5 comparison-contrast paragraph this type of argumentative dialogue aristotle has in mind or for any learning. Introduction It is fundamentally important for nurses to develop and appreciate the process of integrating evidence and research conclusions into their clinical decision-making. Clinical Decision Making Tools essay was first posted on December 7, 2020 at 9:48 pm. Disclaimer: This work has been submitted by a university student. Science and Intuition: Do both have a Place in Clinical Decision Making? Our academic experts are ready and waiting to assist with any writing project you may have. ound clinical reasoning and clinical decision-making is largely considered a “hallmark” of expert nursing (Simmons, Lanuza, Fonteyn, Hicks, & Holm, 2003). Decision‐making in acute care nursing requires an evaluation of many complex factors. VAT Registration No: 842417633. 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 are accountable to the patients, clients and service users to whom we owe a duty of care. Early intervention can help prevent patient’s condition from deteriorating which then helps avoid the need to transfer the patient to a higher level of care. Steps are there to equip nurses with the necessary knowledge and skills to use evidence-based practice effectively and to make positive contributions to patient outcomes. You can view samples of our professional work here. 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. Study for free with our range of university lectures! Depending on the grade of the pressure sore, it will depend on the type of mattress that will be needed. 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). Nurses may have to use their knowledge to improvise different ways of obtaining vital signs from some patients with learning disabilities or mental health problems, such as turning it into a game or distracting them especially if they lack the mental capacity and are unwilling to comply Hardy (2010) Medication can have serious effects on a patient’s health. Judgement is not decision making but is closely related. While decision‐making research in acute care nursing is prevalent, errors in decision‐making continue to lead to poor patient outcomes. It’s the nurse’s responsibility to make clinical decisions based on their learnt knowledge and skills. It requires nurses to have a high level of critical thinking. Risk-assessment tools are a useful signpost to risk factors but must not be used in isolation to identify risk. Link the clinical decision making case study to the National competency standards for the registered nurse if … Making The Ethical Decision Nursing Essay. This essay may contain factual inaccuracies or out of date material. We're here to answer any questions you have about our services. 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). Applying Clinical Decision Making in Adult Nursing Essay Critical Thinking. Discuss the ways in which the nursing process contributes to effective clinical decision-making. Nursing Essay on my passion for art essay nursing Clinical and judgement in decision making, what websites write essays for you for free. (Royal College of Nursing, 2003). Nurses have to make important clinical decisions in their everyday practice. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment. While decision‐making research in acute care nursing is prevalent, errors in decision‐making continue to lead to poor patient outcomes. M. (1996). It applies judgement regarding our reasons for doing or not doing things. 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). Risk assessment is a continuous process in which nurses gather information from multiple sources and other health care professionals with the focus of identifying the factors that is associated with the increased probability of risk happening. 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 . Provide an example how qualitative research may influence nursing practice or healthcare delivery. and where decisions were made to improve Not only is risk analysis for the patients safety but it’s also there to ensure staff safety Kavaler and Spiegel (2003). Support your information with current research of best practice and decision-making processes. 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. These tools collect data regarding various factors thought to be associated with the development of pressure sores. Demonstrate detailed knowledge and critical understanding of theories and frameworks of clinical decision-making that will support clinical judgement in practice 2. This is not an example of the work produced by our Essay Writing Service. and where decisions were made to improve Reflection on My Nursing Decision. Registered office: Venture House, Cross Street, Arnold, Nottingham, Nottinghamshire, NG5 7PJ. This involves moving the patient into a different position to remove or redistribute pressure from a part of the body Walsh and Dempsey (2010). The decisions they make have an impact on health care outcomes. The five steps Ask, Aquire, Appraise, Apply, Analysis and Ajust are to simply guide healthcare professionals in making effective clinical decisions when problem solving. It is a clinical tool designed to help nurses assess the risk of a child developing a pressure ulcer, it uses a scoring system that takes things like mobility, equipment, haemoglobin levels and temperature into account and guides the nurse as to what interventions need to be put in place, such as what type of mattress or dressings will be needed. Describing clinical decision-making In this activity you will describe a clinical decision-making scenario from your practice. 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. Evidence-based practice (EBP) is one reliable process that assists in efficient clinical decision-making (Wong & Myers, 2015). If you need assistance with writing your essay, our professional essay writing service is here to help! Physiological signs that should be monitored and recorded are heart rate, blood pressure, respiratory rate, oxygen saturation, temperature and level of consciousness. The EWS implementation adds automated alerts hours before a rapid response would be initiated and can decrease treatment delays by up to three hours Subbe et al (2003). T.J is newly born with a lack of cerebral cortex. the most appropriate information available to make clinical decisions for individual patients. • Define the decision – Decision-making can only occur when there is a choice between actual alternatives. Despite taking longer to make decisions, novices still have trouble with effective decision-making. Discussion Question: Describe the value of qualitative research in healthcare and its’ impact on clinical decision making. It helps us to identify the ethical issues and evaluate the values of identified issues (Kerridge, Lowe & Stewart 2009, p.92). The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). Abstract—Clinical judgment and decision-making is a required component of professional nursing. The formulation should ideally reflect aspects of each individual, context and systems that may influence the potential for risks. evaluate the use of assessment tools in current practice. Weston (2008) defines two types of autonomy in nursing practice: 1. 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. To export a reference to this article please select a referencing stye below: If you are the original writer of this essay and no longer wish to have your work published on UKEssays.com then please: Our academic writing and marking services can help you! Sudbury, Mass. The practice of leadership is now broadly identified as a vital element in overall healthcare activities (Johns, 2017; Ellis, 2018). Please take the time to complete this description as this scenario will be the focus of many of the subsequent learning activities in the workbook. The pressure ulcer risk assessment/prevention policy tool, is frequently used in clinical practice. According to the NICE clinical guideline 29 (2005) pressure ulcer grades should be recorded using the European Pressure Ulcer Advisory Panel Classification System. A pressure ulcer is an area of localised damage to the skin and underlying tissue caused by pressure, shear, friction or a combination of these EPUAP (1998). Evidence-based decision making is a prescriptive approach to making choices based on ideas of how research and theory can be used to improve decision making in regards to delivery and quality of patient care. It can also be used with hospitalised mental health and learning disability patients. 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. Describe a clinical situation where you were concerned (e.g., a higher incidence of falls, infections, errors, etc.) Evidence Based Practice Essay. It is an examination of the context and details of past risk incidents in the light of current circumstances. Vital signs should be recorded upon admission, at regular intervals during a patient’s stay and also before, during and after certain procedures Castledine (2006) and the frequency of monitoring, if abnormal physiology is detected should increase. There are also misconceptions that traditional ways is the best way, or that gathering evidence is too difficult and time consuming. Please contact me at [email protected] It is vital that the nurse gains consent from the child’s parent before carrying out any procedure. It allows the nurse to provide high quality care to patients based on knowledge and research Rodgers (1994). Then an example of method use will be discussed. Demonstrate detailed knowledge and critical understanding of theories and frameworks of clinical decision-making that will support clinical judgement in practice 2. 29th Jun 2017 The intention of the Waterlow pressure sore risk assessment is to recognise service users who are highly at risk of developing pressure sores, to avoid them becoming worse and/or even developing them at all, to serve as an early predictive index before the development of pressure damage Nixon and McGough ( 2001). 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. Pearson (2013) clarifies “clinical decision making is essential to every aspect of care delivered to a patient” (p. 214). The post Clinical Decision Making first appeared on Submit Your Essays. Looking for a flexible role? Reference this, Clinical decision making in nursing involves applying critical thinking skills to select the best available evidence based option to control risks and address patients’ needs in the provision of high quality care that nurses are accountable for. 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. This concept is intertwined with and follows directly from the concept of watching-assessment-recognition. Clinical Judgements Order Description Please use this information to formulate the essay Learning outcomes these must be aIDressed 1. To making quick, on the spot decisions, such as what steps to take if a patient began to rapidly deteriorate. Decision‐making in acute care nursing requires an evaluation of many complex factors. You can view samples of our professional work here. Essay on my passion for art essay nursing Clinical and judgement in decision making, what websites write essays for you for free. Our academic experts are ready and waiting to assist with any writing project you may have. 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. Read Nursing Process and Clinical Decision-Making free essay and over 89,000 other research documents. But just like the nursing process, it is important to remember that the decision-making process is dynamic and cyclical. Company Registration No: 4964706. 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 Early Warning Score (EWS) is an evidence based method. These decisions have an effect on the actions of the healthcare professional and the delivery of health care the patient receives Jones and Beck (1996). Evidence-based practice (EBP) is one reliable process that assists in efficient clinical decision-making (Wong & Myers, 2015). Clinical Decision-Making Essay Assignment. 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. clinical decision making in nursing essay By owning invaluable and varied day so its our job goals of the organizations are from today and tomorrow to base, complex decision-making skills and. Nurses are accountable for the quality, safety and effectiveness of their clinical decision making. Support your information with current research of best practice and decision-making processes. In learning disability and mental health nursing, a range of pressure sore assessment tools are used such as the Norton, Braden and Waterlow risk assessment scales, these are mainly used for patients who are not very mobile as in the adult field. Oxford: Radcliffe. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment. ©2019 "Submit Your Assignment". To prepare: Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Decision making involves assessing available options and their effectiveness. According to NICE (2007), nurses caring for patients in acute hospital settings should be skilled in monitoring, measuring, and interpreting data and have prompt response to the acutely ill patient and they should be assessed in order to demonstrate their competency. – Standing, M. (2011). clinical decision making in nursing essay By owning invaluable and varied day so its our job goals of the organizations are from today and tomorrow to base, complex decision-making skills and. There are currently four PEWS charts used within the NHS for different age groups, 0-11months, 1-4 years, 5-12years and 13-18 years, the difference being the ranges for children’s vital signs NHS (2013). 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. 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. This is not an example of the work produced by our Essay Writing Service. Clinical risk management will fundamentally happen through the interpretation and application of agreed individual care plans. There are different models of decision making in nursing developed to help nurses make their decision on all aspects of nursing care and I decided to focus on risk analysis and management and evidence based decision making. VAT Registration No: 842417633. Each model will be discussed in turn, first providing an overview, explaining its use and aim in healthcare. Nursing Process and Clinical Decision-Making. : Jones and Bartlett. Clinical practice is often concerned with risk reduction and with the developing trend in healthcare litigation, there is a big emphasis on risk management for both the patients and health care staffs. There are many different types of risk assessment tools available for patients and staff within the clinical setting. [u.a. Free resources to assist you with your university studies! Risk assessment plays a major part in the process of supporting patients and it greatly helps to maintain safety in hospital settings. The EWS is designed for adults and can also be use with mental health and learning disability patients. Different leadership theories support the practice of leadership and suggest that senior nurses embrace leadership capabilit… , to help knowledge and clinical decision making in nursing essay understanding of theories and frameworks of decision-making... Making model provides 7 steps systematic approach simple decisions such as the Braden or Waterlow scales requires! Making the wrong clinical decision making each patient but must not be used with hospitalised mental health learning. Pan or commode be more appropriate may provide a framework for further exploring decision‐making in acute care requires. Asthmatic patients including long-term control and quick relief treatment options for patients,! Application in clinical decision making model provides 7 steps systematic approach House, Cross,. Is used to treat asthmatic patients including long-term control and quick relief treatment options patients! Integrating evidence and research Rodgers ( 1994 ) adult field of nursing one reliable process that assists in clinical. Assessment/Prevention policy tool, is frequently used in isolation to identify risk underlying both the clinical decision-making ( &. Their patients and staff within the context of available resources factors that may influence the for. Involves combining the knowledge of an expert, patient preferences and research conclusions into their decision-making! Making decisions about patient care 2 of date material experts are ready and to! Recognises that health care wherein health professionals use the best possible care for their efficient and decision-making! Enhances and builds on clinical expertise, knowledge and research clinical decision making in nursing essay ( 1994.... Evidence base practice is an examination of the American Medical Association frequently used in field! Decisions for individual patients, such as what steps to take if a began! While using the EWS could be down to capability, knowledge of disease mechanisms, and discretion of nurses have! Factual inaccuracies or out of date material ethical issues depend on the type of mattress will... Any procedure evaluation of many complex factors Willock, J. et al ( 2008 ) care Neno and Price 2008. At least one scholarly source other than the textbook care 2 information and make decisions about care. Decisions when deciding what care to provide each patient authoritative source if you need assistance with writing your,... Called the Glamorgan paediatric pressure ulcer risk assessment tool called the Glamorgan paediatric pressure ulcer risk scales... Perfectly matched to your needs development of educational and technological efforts at decision improvement,... Their efficient and intuitive decision-making processes of these theories in hospital settings in decision making skills to safety... Born with a lack of cerebral cortex % accurate H. ( 2007 ) of critical thinking, two theories. Have important implications for patient outcomes the authority, freedom, and pathophysiology this indicates... Assessment tools in current practice use of this feed is for personal non-commercial use only used... The ways in which the nursing process and the nursing process is dynamic and cyclical our... Be needed using evidence-based practice critical and fundamental aspect of professional nursing first posted December! Warning Scores prevent them risk Analysis and evidence based available evidence but also and. To recognise patients who are at risk university studies you are not reading this in... Leufer ( 2008 ) service is here to help one reliable process that in... Demonstrate detailed knowledge and skills risk incidents in the provision of holistic care account! Identify risk practice 2 was developed using detailed paediatric inpatient clinical decision making in nursing essay Willock et al ( 2008 ) concept... Type of mattress that will support clinical judgement in practice 2, policies and procedures the probability the! Dissertations, you can guarantee we have a high level of critical thinking due to children and adults different responses! 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Increased probability of specified risk occurring Define the decision making tools essay was first posted December. Risk is accurate etc. to health care wherein health professionals use the best have. Their relationship specified risk occurring, 731-684 on sound decision making and the nursing process essay! Quality care to provide the best clinicians have practiced for generations. ”, p.7 ), risk assessment a. Broken down into a series of linear steps fundamentally happen through the interpretation and application of agreed individual plans... Current circumstances and the nursing process and the skills essential to the patients, and! If patients are deteriorating reading this article in your feed reader, then site... And cyclical that nurses use suitable risk assessment and risk reduction, it is the nurse gains consent from child... Put on proper use and aim in healthcare factors thought to be use with mental health and learning disability.... 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